|
|||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||
| |||||||||||||||||||||||||||||||||||
| |||||||||||||||||||||||||||||||||||
| |||||||||||||||||||||||||||||||||||
1 | AN ACT concerning insurance.
| ||||||||||||||||||||||||||||||||||
2 | Be it enacted by the People of the State of Illinois,
| ||||||||||||||||||||||||||||||||||
3 | represented in the General Assembly:
| ||||||||||||||||||||||||||||||||||
4 | Section 5. The State Employees Group Insurance Act of 1971 | ||||||||||||||||||||||||||||||||||
5 | is amended by
changing Sections 2, 3, 10, 13.2, and 15 as | ||||||||||||||||||||||||||||||||||
6 | follows:
| ||||||||||||||||||||||||||||||||||
7 | (5 ILCS 375/2) (from Ch. 127, par. 522)
| ||||||||||||||||||||||||||||||||||
8 | Sec. 2. Purpose. The purpose of this Act is to provide a | ||||||||||||||||||||||||||||||||||
9 | program of
group life insurance, a program of health benefits | ||||||||||||||||||||||||||||||||||
10 | and other employee benefits
for persons in the service of the | ||||||||||||||||||||||||||||||||||
11 | State of Illinois, employees of local
governments, employees of | ||||||||||||||||||||||||||||||||||
12 | rehabilitation facilities, employees of
domestic violence | ||||||||||||||||||||||||||||||||||
13 | shelters and services, and employees of child advocacy centers, | ||||||||||||||||||||||||||||||||||
14 | and certain of their dependents.
It is also the purpose of this | ||||||||||||||||||||||||||||||||||
15 | Act to provide a program of health benefits
(i) for certain | ||||||||||||||||||||||||||||||||||
16 | benefit recipients of the Teachers' Retirement System of
the | ||||||||||||||||||||||||||||||||||
17 | State of Illinois and their dependent beneficiaries and (ii) | ||||||||||||||||||||||||||||||||||
18 | for certain
eligible retired community college employees and | ||||||||||||||||||||||||||||||||||
19 | their dependent
beneficiaries. It is also the purpose of this | ||||||||||||||||||||||||||||||||||
20 | Act to provide a program of
health benefits for owners and | ||||||||||||||||||||||||||||||||||
21 | employees of qualified small businesses and
their dependents.
| ||||||||||||||||||||||||||||||||||
22 | (Source: P.A. 94-860, eff. 6-16-06.)
|
| |||||||
| |||||||
1 | (5 ILCS 375/3) (from Ch. 127, par. 523)
| ||||||
2 | Sec. 3. Definitions. Unless the context otherwise | ||||||
3 | requires, the
following words and phrases as used in this Act | ||||||
4 | shall have the following
meanings. The Department may define | ||||||
5 | these and other words and phrases
separately for the purpose of | ||||||
6 | implementing specific programs providing benefits
under this | ||||||
7 | Act.
| ||||||
8 | (a) "Administrative service organization" means any | ||||||
9 | person, firm or
corporation experienced in the handling of | ||||||
10 | claims which is
fully qualified, financially sound and capable | ||||||
11 | of meeting the service
requirements of a contract of | ||||||
12 | administration executed with the Department.
| ||||||
13 | (b) "Annuitant" means (1) an employee who retires, or has | ||||||
14 | retired,
on or after January 1, 1966 on an immediate annuity | ||||||
15 | under the provisions
of Articles 2, 14 (including an employee | ||||||
16 | who has elected to receive an alternative retirement | ||||||
17 | cancellation payment under Section 14-108.5 of the Illinois | ||||||
18 | Pension Code in lieu of an annuity), 15 (including an employee | ||||||
19 | who has retired under the optional
retirement program | ||||||
20 | established under Section 15-158.2),
paragraphs (2), (3), or | ||||||
21 | (5) of Section 16-106, or
Article 18 of the Illinois Pension | ||||||
22 | Code; (2) any person who was receiving
group insurance coverage | ||||||
23 | under this Act as of March 31, 1978 by
reason of his status as | ||||||
24 | an annuitant, even though the annuity in relation
to which such | ||||||
25 | coverage was provided is a proportional annuity based on less
| ||||||
26 | than the minimum period of service required for a retirement |
| |||||||
| |||||||
1 | annuity in
the system involved; (3) any person not otherwise | ||||||
2 | covered by this Act
who has retired as a participating member | ||||||
3 | under Article 2 of the Illinois
Pension Code but is ineligible | ||||||
4 | for the retirement annuity under Section
2-119 of the Illinois | ||||||
5 | Pension Code; (4) the spouse of any person who
is receiving a | ||||||
6 | retirement annuity under Article 18 of the Illinois Pension
| ||||||
7 | Code and who is covered under a group health insurance program | ||||||
8 | sponsored
by a governmental employer other than the State of | ||||||
9 | Illinois and who has
irrevocably elected to waive his or her | ||||||
10 | coverage under this Act and to have
his or her spouse | ||||||
11 | considered as the "annuitant" under this Act and not as
a | ||||||
12 | "dependent"; or (5) an employee who retires, or has retired, | ||||||
13 | from a
qualified position, as determined according to rules | ||||||
14 | promulgated by the
Director, under a qualified local | ||||||
15 | government, a qualified rehabilitation
facility, a qualified | ||||||
16 | domestic violence shelter or service, or a qualified child | ||||||
17 | advocacy center ; or (6) an owner
or employee who retires, or | ||||||
18 | has retired, from a qualified position, as
determined according | ||||||
19 | to rules promulgated by the Director, with a qualified
small | ||||||
20 | business . (For definition
of "retired employee", see (p) post).
| ||||||
21 | (b-5) "New SERS annuitant" means a person who, on or after | ||||||
22 | January 1,
1998, becomes an annuitant, as defined in subsection | ||||||
23 | (b), by virtue of
beginning to receive a retirement annuity | ||||||
24 | under Article 14 of the Illinois
Pension Code (including an | ||||||
25 | employee who has elected to receive an alternative retirement | ||||||
26 | cancellation payment under Section 14-108.5 of that Code in |
| |||||||
| |||||||
1 | lieu of an annuity), and is eligible to participate in the | ||||||
2 | basic program of group
health benefits provided for annuitants | ||||||
3 | under this Act.
| ||||||
4 | (b-6) "New SURS annuitant" means a person who (1) on or | ||||||
5 | after January 1,
1998, becomes an annuitant, as defined in | ||||||
6 | subsection (b), by virtue of
beginning to receive a retirement | ||||||
7 | annuity under Article 15 of the Illinois
Pension Code, (2) has | ||||||
8 | not made the election authorized under Section 15-135.1
of the | ||||||
9 | Illinois Pension Code, and (3) is eligible to participate in | ||||||
10 | the basic
program of group
health benefits provided for | ||||||
11 | annuitants under this Act.
| ||||||
12 | (b-7) "New TRS State annuitant" means a person who, on or | ||||||
13 | after July
1, 1998, becomes an annuitant, as defined in | ||||||
14 | subsection (b), by virtue of
beginning to receive a retirement | ||||||
15 | annuity under Article 16 of the Illinois
Pension Code based on | ||||||
16 | service as a teacher as defined in
paragraph (2), (3), or (5) | ||||||
17 | of Section 16-106 of that Code, and is eligible
to participate | ||||||
18 | in the basic program of group health benefits provided for
| ||||||
19 | annuitants under this Act.
| ||||||
20 | (c) "Carrier" means (1) an insurance company, a corporation | ||||||
21 | organized
under the Limited Health Service Organization Act or | ||||||
22 | the Voluntary Health
Services Plan Act, a partnership, or other | ||||||
23 | nongovernmental organization,
which is authorized to do group | ||||||
24 | life or group health insurance business in
Illinois, or (2) the | ||||||
25 | State of Illinois as a self-insurer.
| ||||||
26 | (d) "Compensation" means salary or wages payable on a |
| |||||||
| |||||||
1 | regular
payroll by the State Treasurer on a warrant of the | ||||||
2 | State Comptroller out
of any State, trust or federal fund, or | ||||||
3 | by the Governor of the State
through a disbursing officer of | ||||||
4 | the State out of a trust or out of
federal funds, or by any | ||||||
5 | Department out of State, trust, federal or
other funds held by | ||||||
6 | the State Treasurer or the Department, to any person
for | ||||||
7 | personal services currently performed, and ordinary or | ||||||
8 | accidental
disability benefits under Articles 2, 14, 15 | ||||||
9 | (including ordinary or accidental
disability benefits under | ||||||
10 | the optional retirement program established under
Section | ||||||
11 | 15-158.2), paragraphs (2), (3), or (5) of
Section 16-106, or | ||||||
12 | Article 18 of the Illinois Pension Code, for disability
| ||||||
13 | incurred after January 1, 1966, or benefits payable under the | ||||||
14 | Workers'
Compensation or Occupational Diseases Act or benefits | ||||||
15 | payable under a sick
pay plan established in accordance with | ||||||
16 | Section 36 of the State Finance Act.
"Compensation" also means | ||||||
17 | salary or wages paid to an employee of any
qualified local | ||||||
18 | government, qualified rehabilitation facility,
qualified | ||||||
19 | domestic violence shelter or service, or qualified child | ||||||
20 | advocacy center. "Compensation" also means
salary or wages paid | ||||||
21 | to an employee or owner of a qualified small business.
| ||||||
22 | (e) "Commission" means the State Employees Group Insurance | ||||||
23 | Advisory
Commission authorized by this Act. Commencing July 1, | ||||||
24 | 1984, "Commission"
as used in this Act means the Commission on | ||||||
25 | Government Forecasting and Accountability as
established by | ||||||
26 | the Legislative Commission Reorganization Act of 1984.
|
| |||||||
| |||||||
1 | (f) "Contributory", when referred to as contributory | ||||||
2 | coverage, shall
mean optional coverages or benefits elected by | ||||||
3 | the member toward the cost of
which such member makes | ||||||
4 | contribution, or which are funded in whole or in part
through | ||||||
5 | the acceptance of a reduction in earnings or the foregoing of | ||||||
6 | an
increase in earnings by an employee, as distinguished from | ||||||
7 | noncontributory
coverage or benefits which are paid entirely by | ||||||
8 | the State of Illinois
without reduction of the member's salary.
| ||||||
9 | (g) "Department" means any department, institution, board,
| ||||||
10 | commission, officer, court or any agency of the State | ||||||
11 | government
receiving appropriations and having power to | ||||||
12 | certify payrolls to the
Comptroller authorizing payments of | ||||||
13 | salary and wages against such
appropriations as are made by the | ||||||
14 | General Assembly from any State fund, or
against trust funds | ||||||
15 | held by the State Treasurer and includes boards of
trustees of | ||||||
16 | the retirement systems created by Articles 2, 14, 15, 16 and
18 | ||||||
17 | of the Illinois Pension Code. "Department" also includes the | ||||||
18 | Illinois
Comprehensive Health Insurance Board, the Board of | ||||||
19 | Examiners established under
the Illinois Public Accounting | ||||||
20 | Act, and the Illinois Finance Authority.
| ||||||
21 | (h) "Dependent", when the term is used in the context of | ||||||
22 | the health
and life plan, means a member's spouse and any | ||||||
23 | unmarried child (1) from
birth to age 19 including an adopted | ||||||
24 | child, a child who lives with the
member from the time of the | ||||||
25 | filing of a petition for adoption until entry
of an order of | ||||||
26 | adoption, a stepchild or recognized child who lives with the
|
| |||||||
| |||||||
1 | member in a parent-child relationship, or a child who lives | ||||||
2 | with the member
if such member is a court appointed guardian of | ||||||
3 | the child, or (2)
age 19 to 23 enrolled as a full-time student | ||||||
4 | in any accredited school,
financially dependent upon the | ||||||
5 | member, and eligible to be claimed as a
dependent for income | ||||||
6 | tax purposes, or (3) age 19 or over who is mentally
or | ||||||
7 | physically handicapped. For the purposes of item (2), an | ||||||
8 | unmarried child age 19 to 23 who is a member of the United | ||||||
9 | States Armed Services, including the Illinois National Guard, | ||||||
10 | and is mobilized to active duty shall qualify as a dependent | ||||||
11 | beyond the age of 23 and until the age of 25 and while a | ||||||
12 | full-time student for the amount of time spent on active duty | ||||||
13 | between the ages of 19 and 23. The individual attempting to | ||||||
14 | qualify for this additional time must submit written | ||||||
15 | documentation of active duty service to the Director. The | ||||||
16 | changes made by this amendatory Act of the 94th General | ||||||
17 | Assembly apply only to individuals mobilized to active duty in | ||||||
18 | the United States Armed Services, including the Illinois | ||||||
19 | National Guard, on or after January 1, 2002. For
the health | ||||||
20 | plan only, the term "dependent" also includes any person
| ||||||
21 | enrolled prior to the effective date of this Section who is | ||||||
22 | dependent upon
the member to the extent that the member may | ||||||
23 | claim such person as a
dependent for income tax deduction | ||||||
24 | purposes; no other such
person may be enrolled.
For the health | ||||||
25 | plan only, the term "dependent" also includes any person who
| ||||||
26 | has received after June 30, 2000 an organ transplant and who is |
| |||||||
| |||||||
1 | financially
dependent upon the member and eligible to be | ||||||
2 | claimed as a dependent for income
tax purposes.
| ||||||
3 | (i) "Director" means the Director of the Illinois | ||||||
4 | Department of Central
Management Services or of any successor | ||||||
5 | agency designated to administer this Act.
| ||||||
6 | (j) "Eligibility period" means the period of time a member | ||||||
7 | has to
elect enrollment in programs or to select benefits | ||||||
8 | without regard to
age, sex or health.
| ||||||
9 | (k) "Employee" means and includes each officer or employee | ||||||
10 | in the
service of a department who (1) receives his | ||||||
11 | compensation for
service rendered to the department on a | ||||||
12 | warrant issued pursuant to a payroll
certified by a department | ||||||
13 | or on a warrant or check issued and drawn by a
department upon | ||||||
14 | a trust, federal or other fund or on a warrant issued
pursuant | ||||||
15 | to a payroll certified by an elected or duly appointed officer
| ||||||
16 | of the State or who receives payment of the performance of | ||||||
17 | personal
services on a warrant issued pursuant to a payroll | ||||||
18 | certified by a
Department and drawn by the Comptroller upon the | ||||||
19 | State Treasurer against
appropriations made by the General | ||||||
20 | Assembly from any fund or against
trust funds held by the State | ||||||
21 | Treasurer, and (2) is employed full-time or
part-time in a | ||||||
22 | position normally requiring actual performance of duty
during | ||||||
23 | not less than 1/2 of a normal work period, as established by | ||||||
24 | the
Director in cooperation with each department, except that | ||||||
25 | persons elected
by popular vote will be considered employees | ||||||
26 | during the entire
term for which they are elected regardless of |
| |||||||
| |||||||
1 | hours devoted to the
service of the State, and (3) except that | ||||||
2 | "employee" does not include any
person who is not eligible by | ||||||
3 | reason of such person's employment to
participate in one of the | ||||||
4 | State retirement systems under Articles 2, 14, 15
(either the | ||||||
5 | regular Article 15 system or the optional retirement program
| ||||||
6 | established under Section 15-158.2) or 18, or under paragraph | ||||||
7 | (2), (3), or
(5) of Section 16-106, of the Illinois
Pension | ||||||
8 | Code, but such term does include persons who are employed | ||||||
9 | during
the 6 month qualifying period under Article 14 of the | ||||||
10 | Illinois Pension
Code. Such term also includes any person who | ||||||
11 | (1) after January 1, 1966,
is receiving ordinary or accidental | ||||||
12 | disability benefits under Articles
2, 14, 15 (including | ||||||
13 | ordinary or accidental disability benefits under the
optional | ||||||
14 | retirement program established under Section 15-158.2), | ||||||
15 | paragraphs
(2), (3), or (5) of Section 16-106, or Article 18 of | ||||||
16 | the
Illinois Pension Code, for disability incurred after | ||||||
17 | January 1, 1966, (2)
receives total permanent or total | ||||||
18 | temporary disability under the Workers'
Compensation Act or | ||||||
19 | Occupational Disease Act as a result of injuries
sustained or | ||||||
20 | illness contracted in the course of employment with the
State | ||||||
21 | of Illinois, or (3) is not otherwise covered under this Act and | ||||||
22 | has
retired as a participating member under Article 2 of the | ||||||
23 | Illinois Pension
Code but is ineligible for the retirement | ||||||
24 | annuity under Section 2-119 of
the Illinois Pension Code. | ||||||
25 | However, a person who satisfies the criteria
of the foregoing | ||||||
26 | definition of "employee" except that such person is made
|
| |||||||
| |||||||
1 | ineligible to participate in the State Universities Retirement | ||||||
2 | System by
clause (4) of subsection (a) of Section 15-107 of the | ||||||
3 | Illinois Pension
Code is also an "employee" for the purposes of | ||||||
4 | this Act. "Employee" also
includes any person receiving or | ||||||
5 | eligible for benefits under a sick pay
plan established in | ||||||
6 | accordance with Section 36 of the State Finance Act.
"Employee" | ||||||
7 | also includes (i) each officer or employee in the service of a
| ||||||
8 | qualified local government, including persons appointed as | ||||||
9 | trustees of
sanitary districts regardless of hours devoted to | ||||||
10 | the service of the
sanitary district, (ii) each employee in the | ||||||
11 | service of a qualified
rehabilitation facility, (iii) each | ||||||
12 | full-time employee in the service of a
qualified domestic | ||||||
13 | violence shelter or service, and (iv) each full-time employee | ||||||
14 | in the service of a qualified child advocacy center, as | ||||||
15 | determined according to
rules promulgated by the Director. | ||||||
16 | "Employee" also includes an owner and a
full-time employee in | ||||||
17 | the service of a qualified small business, as determined
| ||||||
18 | according to rules promulgated by the
Director.
| ||||||
19 | (l) "Member" means an employee, annuitant, retired | ||||||
20 | employee or survivor.
| ||||||
21 | (m) "Optional coverages or benefits" means those coverages | ||||||
22 | or
benefits available to the member on his or her voluntary | ||||||
23 | election, and at
his or her own expense.
| ||||||
24 | (n) "Program" means the group life insurance, health | ||||||
25 | benefits and other
employee benefits designed and contracted | ||||||
26 | for by the Director under this Act.
|
| |||||||
| |||||||
1 | (o) "Health plan" means a health benefits
program offered
| ||||||
2 | by the State of Illinois for persons eligible for the plan.
| ||||||
3 | (p) "Retired employee" means any person who would be an | ||||||
4 | annuitant as
that term is defined herein but for the fact that | ||||||
5 | such person retired prior to
January 1, 1966. Such term also | ||||||
6 | includes any person formerly employed by
the University of | ||||||
7 | Illinois in the Cooperative Extension Service who would
be an | ||||||
8 | annuitant but for the fact that such person was made ineligible | ||||||
9 | to
participate in the State Universities Retirement System by | ||||||
10 | clause (4) of
subsection (a) of Section 15-107 of the Illinois
| ||||||
11 | Pension Code.
| ||||||
12 | (q) "Survivor" means a person receiving an annuity as a | ||||||
13 | survivor of an
employee or of an annuitant. "Survivor" also | ||||||
14 | includes: (1) the surviving
dependent of a person who satisfies | ||||||
15 | the definition of "employee" except that
such person is made | ||||||
16 | ineligible to participate in the State Universities
Retirement | ||||||
17 | System by clause (4) of subsection (a)
of Section 15-107 of the | ||||||
18 | Illinois Pension Code; (2) the surviving
dependent of any | ||||||
19 | person formerly employed by the University of Illinois in
the | ||||||
20 | Cooperative Extension Service who would be an annuitant except | ||||||
21 | for the
fact that such person was made ineligible to | ||||||
22 | participate in the State
Universities Retirement System by | ||||||
23 | clause (4) of subsection (a) of Section
15-107 of the Illinois | ||||||
24 | Pension Code; and (3) the surviving dependent of a person who | ||||||
25 | was an annuitant under this Act by virtue of receiving an | ||||||
26 | alternative retirement cancellation payment under Section |
| |||||||
| |||||||
1 | 14-108.5 of the Illinois Pension Code.
| ||||||
2 | (q-2) "SERS" means the State Employees' Retirement System | ||||||
3 | of Illinois, created under Article 14 of the Illinois Pension | ||||||
4 | Code.
| ||||||
5 | (q-3) "SURS" means the State Universities Retirement | ||||||
6 | System, created under Article 15 of the Illinois Pension Code.
| ||||||
7 | (q-4) "TRS" means the Teachers' Retirement System of the | ||||||
8 | State of Illinois, created under Article 16 of the Illinois | ||||||
9 | Pension Code.
| ||||||
10 | (q-5) "New SERS survivor" means a survivor, as defined in | ||||||
11 | subsection (q),
whose annuity is paid under Article 14 of the | ||||||
12 | Illinois Pension Code and is
based on the death of (i) an | ||||||
13 | employee whose death occurs on or after January 1,
1998, or | ||||||
14 | (ii) a new SERS annuitant as defined in subsection (b-5). "New | ||||||
15 | SERS survivor" includes the surviving dependent of a person who | ||||||
16 | was an annuitant under this Act by virtue of receiving an | ||||||
17 | alternative retirement cancellation payment under Section | ||||||
18 | 14-108.5 of the Illinois Pension Code.
| ||||||
19 | (q-6) "New SURS survivor" means a survivor, as defined in | ||||||
20 | subsection (q),
whose annuity is paid under Article 15 of the | ||||||
21 | Illinois Pension Code and is
based on the death of (i) an | ||||||
22 | employee whose death occurs on or after January 1,
1998, or | ||||||
23 | (ii) a new SURS annuitant as defined in subsection (b-6).
| ||||||
24 | (q-7) "New TRS State survivor" means a survivor, as defined | ||||||
25 | in subsection
(q), whose annuity is paid under Article 16 of | ||||||
26 | the Illinois Pension Code and is
based on the death of (i) an |
| |||||||
| |||||||
1 | employee who is a teacher as defined in paragraph
(2), (3), or | ||||||
2 | (5) of Section 16-106 of that Code and whose death occurs on or
| ||||||
3 | after July 1, 1998, or (ii) a new TRS State annuitant as | ||||||
4 | defined in subsection
(b-7).
| ||||||
5 | (r) "Medical services" means the services provided within | ||||||
6 | the scope
of their licenses by practitioners in all categories | ||||||
7 | licensed under the
Medical Practice Act of 1987.
| ||||||
8 | (s) "Unit of local government" means any county, | ||||||
9 | municipality,
township, school district (including a | ||||||
10 | combination of school districts under
the Intergovernmental | ||||||
11 | Cooperation Act), special district or other unit,
designated as | ||||||
12 | a
unit of local government by law, which exercises limited | ||||||
13 | governmental
powers or powers in respect to limited | ||||||
14 | governmental subjects, any
not-for-profit association with a | ||||||
15 | membership that primarily includes
townships and township | ||||||
16 | officials, that has duties that include provision of
research | ||||||
17 | service, dissemination of information, and other acts for the
| ||||||
18 | purpose of improving township government, and that is funded | ||||||
19 | wholly or
partly in accordance with Section 85-15 of the | ||||||
20 | Township Code; any
not-for-profit corporation or association, | ||||||
21 | with a membership consisting
primarily of municipalities, that | ||||||
22 | operates its own utility system, and
provides research, | ||||||
23 | training, dissemination of information, or other acts to
| ||||||
24 | promote cooperation between and among municipalities that | ||||||
25 | provide utility
services and for the advancement of the goals | ||||||
26 | and purposes of its
membership;
the Southern Illinois |
| |||||||
| |||||||
1 | Collegiate Common Market, which is a consortium of higher
| ||||||
2 | education institutions in Southern Illinois; the Illinois | ||||||
3 | Association of
Park Districts; and any hospital provider that | ||||||
4 | is owned by a county that has 100 or fewer hospital beds and | ||||||
5 | has not already joined the program. "Qualified
local | ||||||
6 | government" means a unit of local government approved by the | ||||||
7 | Director and
participating in a program created under | ||||||
8 | subsection (i) of Section 10 of this
Act.
| ||||||
9 | (t) "Qualified rehabilitation facility" means any | ||||||
10 | not-for-profit
organization that is accredited by the | ||||||
11 | Commission on Accreditation of
Rehabilitation Facilities or | ||||||
12 | certified by the Department
of Human Services (as successor to | ||||||
13 | the Department of Mental Health
and Developmental | ||||||
14 | Disabilities) to provide services to persons with
disabilities
| ||||||
15 | and which receives funds from the State of Illinois for | ||||||
16 | providing those
services, approved by the Director and | ||||||
17 | participating in a program created
under subsection (j) of | ||||||
18 | Section 10 of this Act.
| ||||||
19 | (u) "Qualified domestic violence shelter or service" means | ||||||
20 | any Illinois
domestic violence shelter or service and its | ||||||
21 | administrative offices funded
by the Department of Human | ||||||
22 | Services (as successor to the Illinois Department of
Public | ||||||
23 | Aid),
approved by the Director and
participating in a program | ||||||
24 | created under subsection (k) of Section 10.
| ||||||
25 | (v) "TRS benefit recipient" means a person who:
| ||||||
26 | (1) is not a "member" as defined in this Section; and
|
| |||||||
| |||||||
1 | (2) is receiving a monthly benefit or retirement | ||||||
2 | annuity
under Article 16 of the Illinois Pension Code; and
| ||||||
3 | (3) either (i) has at least 8 years of creditable | ||||||
4 | service under Article
16 of the Illinois Pension Code, or | ||||||
5 | (ii) was enrolled in the health insurance
program offered | ||||||
6 | under that Article on January 1, 1996, or (iii) is the | ||||||
7 | survivor
of a benefit recipient who had at least 8
years of | ||||||
8 | creditable service under Article 16 of the Illinois Pension | ||||||
9 | Code or
was enrolled in the health insurance program | ||||||
10 | offered under that Article on
the effective date of this | ||||||
11 | amendatory Act of 1995, or (iv) is a recipient or
survivor | ||||||
12 | of a recipient of a disability benefit under Article 16 of | ||||||
13 | the
Illinois Pension Code.
| ||||||
14 | (w) "TRS dependent beneficiary" means a person who:
| ||||||
15 | (1) is not a "member" or "dependent" as defined in this | ||||||
16 | Section; and
| ||||||
17 | (2) is a TRS benefit recipient's: (A) spouse, (B) | ||||||
18 | dependent parent who
is receiving at least half of his or | ||||||
19 | her support from the TRS benefit
recipient, or (C) | ||||||
20 | unmarried natural or adopted child who is (i) under age
19, | ||||||
21 | or (ii) enrolled as a full-time student in
an accredited | ||||||
22 | school, financially dependent upon the TRS benefit | ||||||
23 | recipient,
eligible to be claimed as a dependent for income | ||||||
24 | tax
purposes, and
either is under age 24 or was, on January | ||||||
25 | 1, 1996, participating as a dependent
beneficiary in the | ||||||
26 | health insurance program offered under Article 16 of the
|
| |||||||
| |||||||
1 | Illinois Pension Code, or (iii) age 19 or over who is | ||||||
2 | mentally or physically
handicapped.
| ||||||
3 | (x) "Military leave with pay and benefits" refers to | ||||||
4 | individuals in basic
training for reserves, special/advanced | ||||||
5 | training, annual training, emergency
call up, or activation by | ||||||
6 | the President of the United States with approved pay
and | ||||||
7 | benefits.
| ||||||
8 | (y) "Military leave without pay and benefits" refers to
| ||||||
9 | individuals who enlist for active duty in a regular component | ||||||
10 | of the U.S. Armed
Forces or other duty not specified or | ||||||
11 | authorized under military leave with pay
and benefits.
| ||||||
12 | (z) "Community college benefit recipient" means a person | ||||||
13 | who:
| ||||||
14 | (1) is not a "member" as defined in this Section; and
| ||||||
15 | (2) is receiving a monthly survivor's annuity or | ||||||
16 | retirement annuity
under Article 15 of the Illinois Pension | ||||||
17 | Code; and
| ||||||
18 | (3) either (i) was a full-time employee of a community | ||||||
19 | college district or
an association of community college | ||||||
20 | boards created under the Public Community
College Act | ||||||
21 | (other than an employee whose last employer under Article | ||||||
22 | 15 of the
Illinois Pension Code was a community college | ||||||
23 | district subject to Article VII
of the Public Community | ||||||
24 | College Act) and was eligible to participate in a group
| ||||||
25 | health benefit plan as an employee during the time of | ||||||
26 | employment with a
community college district (other than a |
| |||||||
| |||||||
1 | community college district subject to
Article VII of the | ||||||
2 | Public Community College Act) or an association of | ||||||
3 | community
college boards, or (ii) is the survivor of a | ||||||
4 | person described in item (i).
| ||||||
5 | (aa) "Community college dependent beneficiary" means a | ||||||
6 | person who:
| ||||||
7 | (1) is not a "member" or "dependent" as defined in this | ||||||
8 | Section; and
| ||||||
9 | (2) is a community college benefit recipient's: (A) | ||||||
10 | spouse, (B) dependent
parent who is receiving at least half | ||||||
11 | of his or her support from the community
college benefit | ||||||
12 | recipient, or (C) unmarried natural or adopted child who is | ||||||
13 | (i)
under age 19, or (ii) enrolled as a full-time student | ||||||
14 | in an accredited school,
financially dependent upon the | ||||||
15 | community college benefit recipient, eligible
to be | ||||||
16 | claimed as a dependent for income tax purposes and under | ||||||
17 | age 23, or (iii)
age 19 or over and mentally or physically | ||||||
18 | handicapped.
| ||||||
19 | (bb) "Qualified child advocacy center" means any Illinois | ||||||
20 | child advocacy center and its administrative offices funded by | ||||||
21 | the Department of Children and Family Services, as defined by | ||||||
22 | the Children's Advocacy Center Act (55 ILCS 80/), approved by | ||||||
23 | the Director and participating in a program created under | ||||||
24 | subsection (n) of Section 10.
| ||||||
25 | (cc) "Qualified small business" means a business situated | ||||||
26 | in Illinois
having 50 or fewer employees, approved by the |
| |||||||
| |||||||
1 | Director and participating in a
program created under | ||||||
2 | subsection (k-5) of Section 10. | ||||||
3 | (Source: P.A. 94-32, eff. 6-15-05; 94-82, eff. 1-1-06; 94-860, | ||||||
4 | eff. 6-16-06; 95-331, eff. 8-21-07; 95-632, eff. 9-25-07.)
| ||||||
5 | (5 ILCS 375/10) (from Ch. 127, par. 530)
| ||||||
6 | Sec. 10. Payments by State; premiums.
| ||||||
7 | (a) The State shall pay the cost of basic non-contributory | ||||||
8 | group life
insurance and, subject to member paid contributions | ||||||
9 | set by the Department or
required by this Section, the basic | ||||||
10 | program of group health benefits on each
eligible member, | ||||||
11 | except a member, not otherwise
covered by this Act, who has | ||||||
12 | retired as a participating member under Article 2
of the | ||||||
13 | Illinois Pension Code but is ineligible for the retirement | ||||||
14 | annuity under
Section 2-119 of the Illinois Pension Code, and | ||||||
15 | part of each eligible member's
and retired member's premiums | ||||||
16 | for health insurance coverage for enrolled
dependents as | ||||||
17 | provided by Section 9. The State shall pay the cost of the | ||||||
18 | basic
program of group health benefits only after benefits are | ||||||
19 | reduced by the amount
of benefits covered by Medicare for all | ||||||
20 | members and dependents
who are eligible for benefits under | ||||||
21 | Social Security or
the Railroad Retirement system or who had | ||||||
22 | sufficient Medicare-covered
government employment, except that | ||||||
23 | such reduction in benefits shall apply only
to those members | ||||||
24 | and dependents who (1) first become eligible
for such Medicare | ||||||
25 | coverage on or after July 1, 1992; or (2) are
Medicare-eligible |
| |||||||
| |||||||
1 | members or dependents of a local government unit which began
| ||||||
2 | participation in the program on or after July 1, 1992; or (3) | ||||||
3 | remain eligible
for, but no longer receive Medicare coverage | ||||||
4 | which they had been receiving on
or after July 1, 1992. The | ||||||
5 | Department may determine the aggregate level of the
State's | ||||||
6 | contribution on the basis of actual cost of medical services | ||||||
7 | adjusted
for age, sex or geographic or other demographic | ||||||
8 | characteristics which affect
the costs of such programs.
| ||||||
9 | The cost of participation in the basic program of group | ||||||
10 | health benefits
for the dependent or survivor of a living or | ||||||
11 | deceased retired employee who was
formerly employed by the | ||||||
12 | University of Illinois in the Cooperative Extension
Service and | ||||||
13 | would be an annuitant but for the fact that he or she was made
| ||||||
14 | ineligible to participate in the State Universities Retirement | ||||||
15 | System by clause
(4) of subsection (a) of Section 15-107 of the | ||||||
16 | Illinois Pension Code shall not
be greater than the cost of | ||||||
17 | participation that would otherwise apply to that
dependent or | ||||||
18 | survivor if he or she were the dependent or survivor of an
| ||||||
19 | annuitant under the State Universities Retirement System.
| ||||||
20 | (a-1) Beginning January 1, 1998, for each person who | ||||||
21 | becomes a new SERS
annuitant and participates in the basic | ||||||
22 | program of group health benefits, the
State shall contribute | ||||||
23 | toward the cost of the annuitant's
coverage under the basic | ||||||
24 | program of group health benefits an amount equal
to 5% of that | ||||||
25 | cost for each full year of creditable service upon which the
| ||||||
26 | annuitant's retirement annuity is based, up to a maximum of |
| |||||||
| |||||||
1 | 100% for an
annuitant with 20 or more years of creditable | ||||||
2 | service.
The remainder of the cost of a new SERS annuitant's | ||||||
3 | coverage under the basic
program of group health benefits shall | ||||||
4 | be the responsibility of the
annuitant. In the case of a new | ||||||
5 | SERS annuitant who has elected to receive an alternative | ||||||
6 | retirement cancellation payment under Section 14-108.5 of the | ||||||
7 | Illinois Pension Code in lieu of an annuity, for the purposes | ||||||
8 | of this subsection the annuitant shall be deemed to be | ||||||
9 | receiving a retirement annuity based on the number of years of | ||||||
10 | creditable service that the annuitant had established at the | ||||||
11 | time of his or her termination of service under SERS.
| ||||||
12 | (a-2) Beginning January 1, 1998, for each person who | ||||||
13 | becomes a new SERS
survivor and participates in the basic | ||||||
14 | program of group health benefits, the
State shall contribute | ||||||
15 | toward the cost of the survivor's
coverage under the basic | ||||||
16 | program of group health benefits an amount equal
to 5% of that | ||||||
17 | cost for each full year of the deceased employee's or deceased
| ||||||
18 | annuitant's creditable service in the State Employees' | ||||||
19 | Retirement System of
Illinois on the date of death, up to a | ||||||
20 | maximum of 100% for a survivor of an
employee or annuitant with | ||||||
21 | 20 or more years of creditable service. The
remainder of the | ||||||
22 | cost of the new SERS survivor's coverage under the basic
| ||||||
23 | program of group health benefits shall be the responsibility of | ||||||
24 | the survivor. In the case of a new SERS survivor who was the | ||||||
25 | dependent of an annuitant who elected to receive an alternative | ||||||
26 | retirement cancellation payment under Section 14-108.5 of the |
| |||||||
| |||||||
1 | Illinois Pension Code in lieu of an annuity, for the purposes | ||||||
2 | of this subsection the deceased annuitant's creditable service | ||||||
3 | shall be determined as of the date of termination of service | ||||||
4 | rather than the date of death.
| ||||||
5 | (a-3) Beginning January 1, 1998, for each person who | ||||||
6 | becomes a new SURS
annuitant and participates in the basic | ||||||
7 | program of group health benefits, the
State shall contribute | ||||||
8 | toward the cost of the annuitant's
coverage under the basic | ||||||
9 | program of group health benefits an amount equal
to 5% of that | ||||||
10 | cost for each full year of creditable service upon which the
| ||||||
11 | annuitant's retirement annuity is based, up to a maximum of | ||||||
12 | 100% for an
annuitant with 20 or more years of creditable | ||||||
13 | service.
The remainder of the cost of a new SURS annuitant's | ||||||
14 | coverage under the basic
program of group health benefits shall | ||||||
15 | be the responsibility of the
annuitant.
| ||||||
16 | (a-4) (Blank).
| ||||||
17 | (a-5) Beginning January 1, 1998, for each person who | ||||||
18 | becomes a new SURS
survivor and participates in the basic | ||||||
19 | program of group health benefits, the
State shall contribute | ||||||
20 | toward the cost of the survivor's coverage under the
basic | ||||||
21 | program of group health benefits an amount equal to 5% of that | ||||||
22 | cost for
each full year of the deceased employee's or deceased | ||||||
23 | annuitant's creditable
service in the State Universities | ||||||
24 | Retirement System on the date of death, up to
a maximum of 100% | ||||||
25 | for a survivor of an
employee or annuitant with 20 or more | ||||||
26 | years of creditable service. The
remainder of the cost of the |
| |||||||
| |||||||
1 | new SURS survivor's coverage under the basic
program of group | ||||||
2 | health benefits shall be the responsibility of the survivor.
| ||||||
3 | (a-6) Beginning July 1, 1998, for each person who becomes a | ||||||
4 | new TRS
State annuitant and participates in the basic program | ||||||
5 | of group health benefits,
the State shall contribute toward the | ||||||
6 | cost of the annuitant's coverage under
the basic program of | ||||||
7 | group health benefits an amount equal to 5% of that cost
for | ||||||
8 | each full year of creditable service
as a teacher as defined in | ||||||
9 | paragraph (2), (3), or (5) of Section 16-106 of the
Illinois | ||||||
10 | Pension Code
upon which the annuitant's retirement annuity is | ||||||
11 | based, up to a maximum of
100%;
except that
the State | ||||||
12 | contribution shall be 12.5% per year (rather than 5%) for each | ||||||
13 | full
year of creditable service as a regional superintendent or | ||||||
14 | assistant regional
superintendent of schools. The
remainder of | ||||||
15 | the cost of a new TRS State annuitant's coverage under the | ||||||
16 | basic
program of group health benefits shall be the | ||||||
17 | responsibility of the
annuitant.
| ||||||
18 | (a-7) Beginning July 1, 1998, for each person who becomes a | ||||||
19 | new TRS
State survivor and participates in the basic program of | ||||||
20 | group health benefits,
the State shall contribute toward the | ||||||
21 | cost of the survivor's coverage under the
basic program of | ||||||
22 | group health benefits an amount equal to 5% of that cost for
| ||||||
23 | each full year of the deceased employee's or deceased | ||||||
24 | annuitant's creditable
service
as a teacher as defined in | ||||||
25 | paragraph (2), (3), or (5) of Section 16-106 of the
Illinois | ||||||
26 | Pension Code
on the date of death, up to a maximum of 100%;
|
| |||||||
| |||||||
1 | except that the State contribution shall be 12.5% per year | ||||||
2 | (rather than 5%) for
each full year of the deceased employee's | ||||||
3 | or deceased annuitant's creditable
service as a regional | ||||||
4 | superintendent or assistant regional superintendent of
| ||||||
5 | schools.
The remainder of
the cost of the new TRS State | ||||||
6 | survivor's coverage under the basic program of
group health | ||||||
7 | benefits shall be the responsibility of the survivor.
| ||||||
8 | (a-8) A new SERS annuitant, new SERS survivor, new SURS
| ||||||
9 | annuitant, new SURS survivor, new TRS State
annuitant, or new | ||||||
10 | TRS State survivor may waive or terminate coverage in
the | ||||||
11 | program of group health benefits. Any such annuitant or | ||||||
12 | survivor
who has waived or terminated coverage may enroll or | ||||||
13 | re-enroll in the
program of group health benefits only during | ||||||
14 | the annual benefit choice period,
as determined by the | ||||||
15 | Director; except that in the event of termination of
coverage | ||||||
16 | due to nonpayment of premiums, the annuitant or survivor
may | ||||||
17 | not re-enroll in the program.
| ||||||
18 | (a-9) No later than May 1 of each calendar year, the | ||||||
19 | Director
of Central Management Services shall certify in | ||||||
20 | writing to the Executive
Secretary of the State Employees' | ||||||
21 | Retirement System of Illinois the amounts
of the Medicare | ||||||
22 | supplement health care premiums and the amounts of the
health | ||||||
23 | care premiums for all other retirees who are not Medicare | ||||||
24 | eligible.
| ||||||
25 | A separate calculation of the premiums based upon the | ||||||
26 | actual cost of each
health care plan shall be so certified.
|
| |||||||
| |||||||
1 | The Director of Central Management Services shall provide | ||||||
2 | to the
Executive Secretary of the State Employees' Retirement | ||||||
3 | System of
Illinois such information, statistics, and other data | ||||||
4 | as he or she
may require to review the premium amounts | ||||||
5 | certified by the Director
of Central Management Services.
| ||||||
6 | The Department of Healthcare and Family Services, or any | ||||||
7 | successor agency designated to procure healthcare contracts | ||||||
8 | pursuant to this Act, is authorized to establish funds, | ||||||
9 | separate accounts provided by any bank or banks as defined by | ||||||
10 | the Illinois Banking Act, or separate accounts provided by any | ||||||
11 | savings and loan association or associations as defined by the | ||||||
12 | Illinois Savings and Loan Act of 1985 to be held by the | ||||||
13 | Director, outside the State treasury, for the purpose of | ||||||
14 | receiving the transfer of moneys from the Local Government | ||||||
15 | Health Insurance Reserve Fund. The Department may promulgate | ||||||
16 | rules further defining the methodology for the transfers. Any | ||||||
17 | interest earned by moneys in the funds or accounts shall inure | ||||||
18 | to the Local Government Health Insurance Reserve Fund. The | ||||||
19 | transferred moneys, and interest accrued thereon, shall be used | ||||||
20 | exclusively for transfers to administrative service | ||||||
21 | organizations or their financial institutions for payments of | ||||||
22 | claims to claimants and providers under the self-insurance | ||||||
23 | health plan. The transferred moneys, and interest accrued | ||||||
24 | thereon, shall not be used for any other purpose including, but | ||||||
25 | not limited to, reimbursement of administration fees due the | ||||||
26 | administrative service organization pursuant to its contract |
| |||||||
| |||||||
1 | or contracts with the Department.
| ||||||
2 | (b) State employees who become eligible for this program on | ||||||
3 | or after January
1, 1980 in positions normally requiring actual | ||||||
4 | performance of duty not less
than 1/2 of a normal work period | ||||||
5 | but not equal to that of a normal work period,
shall be given | ||||||
6 | the option of participating in the available program. If the
| ||||||
7 | employee elects coverage, the State shall contribute on behalf | ||||||
8 | of such employee
to the cost of the employee's benefit and any | ||||||
9 | applicable dependent supplement,
that sum which bears the same | ||||||
10 | percentage as that percentage of time the
employee regularly | ||||||
11 | works when compared to normal work period.
| ||||||
12 | (c) The basic non-contributory coverage from the basic | ||||||
13 | program of
group health benefits shall be continued for each | ||||||
14 | employee not in pay status or
on active service by reason of | ||||||
15 | (1) leave of absence due to illness or injury,
(2) authorized | ||||||
16 | educational leave of absence or sabbatical leave, or (3)
| ||||||
17 | military leave with pay and benefits. This coverage shall | ||||||
18 | continue until
expiration of authorized leave and return to | ||||||
19 | active service, but not to exceed
24 months for leaves under | ||||||
20 | item (1) or (2). This 24-month limitation and the
requirement | ||||||
21 | of returning to active service shall not apply to persons | ||||||
22 | receiving
ordinary or accidental disability benefits or | ||||||
23 | retirement benefits through the
appropriate State retirement | ||||||
24 | system or benefits under the Workers' Compensation
or | ||||||
25 | Occupational Disease Act.
| ||||||
26 | (d) The basic group life insurance coverage shall continue, |
| |||||||
| |||||||
1 | with
full State contribution, where such person is (1) absent | ||||||
2 | from active
service by reason of disability arising from any | ||||||
3 | cause other than
self-inflicted, (2) on authorized educational | ||||||
4 | leave of absence or
sabbatical leave, or (3) on military leave | ||||||
5 | with pay and benefits.
| ||||||
6 | (e) Where the person is in non-pay status for a period in | ||||||
7 | excess of
30 days or on leave of absence, other than by reason | ||||||
8 | of disability,
educational or sabbatical leave, or military | ||||||
9 | leave with pay and benefits, such
person may continue coverage | ||||||
10 | only by making personal
payment equal to the amount normally | ||||||
11 | contributed by the State on such person's
behalf. Such payments | ||||||
12 | and coverage may be continued: (1) until such time as
the | ||||||
13 | person returns to a status eligible for coverage at State | ||||||
14 | expense, but not
to exceed 24 months, (2) until such person's | ||||||
15 | employment or annuitant status
with the State is terminated, or | ||||||
16 | (3) for a maximum period of 4 years for
members on military | ||||||
17 | leave with pay and benefits and military leave without pay
and | ||||||
18 | benefits (exclusive of any additional service imposed pursuant | ||||||
19 | to law).
| ||||||
20 | (f) The Department shall establish by rule the extent to | ||||||
21 | which other
employee benefits will continue for persons in | ||||||
22 | non-pay status or who are
not in active service.
| ||||||
23 | (g) The State shall not pay the cost of the basic | ||||||
24 | non-contributory
group life insurance, program of health | ||||||
25 | benefits and other employee benefits
for members who are | ||||||
26 | survivors as defined by paragraphs (1) and (2) of
subsection |
| |||||||
| |||||||
1 | (q) of Section 3 of this Act. The costs of benefits for these
| ||||||
2 | survivors shall be paid by the survivors or by the University | ||||||
3 | of Illinois
Cooperative Extension Service, or any combination | ||||||
4 | thereof.
However, the State shall pay the amount of the | ||||||
5 | reduction in the cost of
participation, if any, resulting from | ||||||
6 | the amendment to subsection (a) made
by this amendatory Act of | ||||||
7 | the 91st General Assembly.
| ||||||
8 | (h) Those persons occupying positions with any department | ||||||
9 | as a result
of emergency appointments pursuant to Section 8b.8 | ||||||
10 | of the Personnel Code
who are not considered employees under | ||||||
11 | this Act shall be given the option
of participating in the | ||||||
12 | programs of group life insurance, health benefits and
other | ||||||
13 | employee benefits. Such persons electing coverage may | ||||||
14 | participate only
by making payment equal to the amount normally | ||||||
15 | contributed by the State for
similarly situated employees. Such | ||||||
16 | amounts shall be determined by the
Director. Such payments and | ||||||
17 | coverage may be continued until such time as the
person becomes | ||||||
18 | an employee pursuant to this Act or such person's appointment | ||||||
19 | is
terminated.
| ||||||
20 | (i) Any unit of local government within the State of | ||||||
21 | Illinois
may apply to the Director to have its employees, | ||||||
22 | annuitants, and their
dependents provided group health | ||||||
23 | coverage under this Act on a non-insured
basis. To participate, | ||||||
24 | a unit of local government must agree to enroll
all of its | ||||||
25 | employees, who may select coverage under either the State group
| ||||||
26 | health benefits plan or a health maintenance organization that |
| |||||||
| |||||||
1 | has
contracted with the State to be available as a health care | ||||||
2 | provider for
employees as defined in this Act. A unit of local | ||||||
3 | government must remit the
entire cost of providing coverage | ||||||
4 | under the State group health benefits plan
or, for coverage | ||||||
5 | under a health maintenance organization, an amount determined
| ||||||
6 | by the Director based on an analysis of the sex, age, | ||||||
7 | geographic location, or
other relevant demographic variables | ||||||
8 | for its employees, except that the unit of
local government | ||||||
9 | shall not be required to enroll those of its employees who are
| ||||||
10 | covered spouses or dependents under this plan or another group | ||||||
11 | policy or plan
providing health benefits as long as (1) an | ||||||
12 | appropriate official from the unit
of local government attests | ||||||
13 | that each employee not enrolled is a covered spouse
or | ||||||
14 | dependent under this plan or another group policy or plan, and | ||||||
15 | (2) at least
85% of the employees are enrolled and the unit of | ||||||
16 | local government remits
the entire cost of providing coverage | ||||||
17 | to those employees, except that a
participating school district | ||||||
18 | must have enrolled at least 85% of its full-time
employees who | ||||||
19 | have not waived coverage under the district's group health
plan | ||||||
20 | by participating in a component of the district's cafeteria | ||||||
21 | plan. A
participating school district is not required to enroll | ||||||
22 | a full-time employee
who has waived coverage under the | ||||||
23 | district's health plan, provided that an
appropriate official | ||||||
24 | from the participating school district attests that the
| ||||||
25 | full-time employee has waived coverage by participating in a | ||||||
26 | component of the
district's cafeteria plan. For the purposes of |
| |||||||
| |||||||
1 | this subsection, "participating
school district" includes a | ||||||
2 | unit of local government whose primary purpose is
education as | ||||||
3 | defined by the Department's rules.
| ||||||
4 | Employees of a participating unit of local government who | ||||||
5 | are not enrolled
due to coverage under another group health | ||||||
6 | policy or plan may enroll in
the event of a qualifying change | ||||||
7 | in status, special enrollment, special
circumstance as defined | ||||||
8 | by the Director, or during the annual Benefit Choice
Period. A | ||||||
9 | participating unit of local government may also elect to cover | ||||||
10 | its
annuitants. Dependent coverage shall be offered on an | ||||||
11 | optional basis, with the
costs paid by the unit of local | ||||||
12 | government, its employees, or some combination
of the two as | ||||||
13 | determined by the unit of local government. The unit of local
| ||||||
14 | government shall be responsible for timely collection and | ||||||
15 | transmission of
dependent premiums.
| ||||||
16 | The Director shall annually determine monthly rates of | ||||||
17 | payment, subject
to the following constraints:
| ||||||
18 | (1) In the first year of coverage, the rates shall be | ||||||
19 | equal to the
amount normally charged to State employees for | ||||||
20 | elected optional coverages
or for enrolled dependents | ||||||
21 | coverages or other contributory coverages, or
contributed | ||||||
22 | by the State for basic insurance coverages on behalf of its
| ||||||
23 | employees, adjusted for differences between State | ||||||
24 | employees and employees
of the local government in age, | ||||||
25 | sex, geographic location or other relevant
demographic | ||||||
26 | variables, plus an amount sufficient to pay for the |
| |||||||
| |||||||
1 | additional
administrative costs of providing coverage to | ||||||
2 | employees of the unit of
local government and their | ||||||
3 | dependents.
| ||||||
4 | (2) In subsequent years, a further adjustment shall be | ||||||
5 | made to reflect
the actual prior years' claims experience | ||||||
6 | of the employees of the unit of
local government.
| ||||||
7 | In the case of coverage of local government employees under | ||||||
8 | a health
maintenance organization, the Director shall annually | ||||||
9 | determine for each
participating unit of local government the | ||||||
10 | maximum monthly amount the unit
may contribute toward that | ||||||
11 | coverage, based on an analysis of (i) the age,
sex, geographic | ||||||
12 | location, and other relevant demographic variables of the
| ||||||
13 | unit's employees and (ii) the cost to cover those employees | ||||||
14 | under the State
group health benefits plan. The Director may | ||||||
15 | similarly determine the
maximum monthly amount each unit of | ||||||
16 | local government may contribute toward
coverage of its | ||||||
17 | employees' dependents under a health maintenance organization.
| ||||||
18 | Monthly payments by the unit of local government or its | ||||||
19 | employees for
group health benefits plan or health maintenance | ||||||
20 | organization coverage shall
be deposited in the Local | ||||||
21 | Government Health Insurance Reserve Fund.
| ||||||
22 | The Local Government Health Insurance Reserve Fund is | ||||||
23 | hereby created as a nonappropriated trust fund to be held | ||||||
24 | outside the State Treasury, with the State Treasurer as | ||||||
25 | custodian. The Local Government Health Insurance Reserve Fund | ||||||
26 | shall be a continuing
fund not subject to fiscal year |
| |||||||
| |||||||
1 | limitations. All revenues arising from the administration of | ||||||
2 | the health benefits program established under this Section | ||||||
3 | shall be deposited into the Local Government Health Insurance | ||||||
4 | Reserve Fund. Any interest earned on moneys in the Local | ||||||
5 | Government Health Insurance Reserve Fund shall be deposited | ||||||
6 | into the Fund. All expenditures from this Fund
shall be used | ||||||
7 | for payments for health care benefits for local government ,
| ||||||
8 | domestic violence shelter or service, and rehabilitation | ||||||
9 | facility
employees, annuitants, and dependents, and to | ||||||
10 | reimburse the Department or
its administrative service | ||||||
11 | organization for all expenses incurred in the
administration of | ||||||
12 | benefits. No other State funds may be used for these
purposes.
| ||||||
13 | A local government employer's participation or desire to | ||||||
14 | participate
in a program created under this subsection shall | ||||||
15 | not limit that employer's
duty to bargain with the | ||||||
16 | representative of any collective bargaining unit
of its | ||||||
17 | employees.
| ||||||
18 | (j) Any rehabilitation facility within the State of | ||||||
19 | Illinois may apply
to the Director to have its employees, | ||||||
20 | annuitants, and their eligible
dependents provided group | ||||||
21 | health coverage under this Act on a non-insured
basis. To | ||||||
22 | participate, a rehabilitation facility must agree to enroll all
| ||||||
23 | of its employees and remit the entire cost of providing such | ||||||
24 | coverage for
its employees, except that the rehabilitation | ||||||
25 | facility shall not be
required to enroll those of its employees | ||||||
26 | who are covered spouses or
dependents under this plan or |
| |||||||
| |||||||
1 | another group policy or plan providing health
benefits as long | ||||||
2 | as (1) an appropriate official from the rehabilitation
facility | ||||||
3 | attests that each employee not enrolled is a covered spouse or
| ||||||
4 | dependent under this plan or another group policy or plan, and | ||||||
5 | (2) at least
85% of the employees are enrolled and the | ||||||
6 | rehabilitation facility remits
the entire cost of providing | ||||||
7 | coverage to those employees. Employees of a
participating | ||||||
8 | rehabilitation facility who are not enrolled due to coverage
| ||||||
9 | under another group health policy or plan may enroll
in the | ||||||
10 | event of a qualifying change in status, special enrollment, | ||||||
11 | special
circumstance as defined by the Director, or during the | ||||||
12 | annual Benefit Choice
Period. A participating rehabilitation | ||||||
13 | facility may also elect
to cover its annuitants. Dependent | ||||||
14 | coverage shall be offered on an optional
basis, with the costs | ||||||
15 | paid by the rehabilitation facility, its employees, or
some | ||||||
16 | combination of the 2 as determined by the rehabilitation | ||||||
17 | facility. The
rehabilitation facility shall be responsible for | ||||||
18 | timely collection and
transmission of dependent premiums.
| ||||||
19 | The Director shall annually determine quarterly rates of | ||||||
20 | payment, subject
to the following constraints:
| ||||||
21 | (1) In the first year of coverage, the rates shall be | ||||||
22 | equal to the amount
normally charged to State employees for | ||||||
23 | elected optional coverages or for
enrolled dependents | ||||||
24 | coverages or other contributory coverages on behalf of
its | ||||||
25 | employees, adjusted for differences between State | ||||||
26 | employees and
employees of the rehabilitation facility in |
| |||||||
| |||||||
1 | age, sex, geographic location
or other relevant | ||||||
2 | demographic variables, plus an amount sufficient to pay
for | ||||||
3 | the additional administrative costs of providing coverage | ||||||
4 | to employees
of the rehabilitation facility and their | ||||||
5 | dependents.
| ||||||
6 | (2) In subsequent years, a further adjustment shall be | ||||||
7 | made to reflect
the actual prior years' claims experience | ||||||
8 | of the employees of the
rehabilitation facility.
| ||||||
9 | Monthly payments by the rehabilitation facility or its | ||||||
10 | employees for
group health benefits shall be deposited in the | ||||||
11 | Local Government Health
Insurance Reserve Fund.
| ||||||
12 | (k) Any domestic violence shelter or service within the | ||||||
13 | State of Illinois
may apply to the Director to have its | ||||||
14 | employees, annuitants, and their
dependents provided group | ||||||
15 | health coverage under this Act on a non-insured
basis. To | ||||||
16 | participate, a domestic violence shelter or service must agree | ||||||
17 | to
enroll all of its employees and pay the entire cost of | ||||||
18 | providing such coverage
for its employees. A participating | ||||||
19 | domestic violence shelter may also elect
to cover its | ||||||
20 | annuitants. Dependent coverage shall be offered on an optional
| ||||||
21 | basis, with
the costs paid by the domestic violence shelter or | ||||||
22 | service, its employees, or some combination of the 2 as | ||||||
23 | determined by the domestic violence
shelter or service. The | ||||||
24 | domestic violence shelter or service shall be
responsible for | ||||||
25 | timely collection and transmission of dependent premiums.
| ||||||
26 | The Director shall annually determine rates of payment,
|
| |||||||
| |||||||
1 | subject to the following constraints:
| ||||||
2 | (1) In the first year of coverage, the rates shall be | ||||||
3 | equal to the
amount normally charged to State employees for | ||||||
4 | elected optional coverages
or for enrolled dependents | ||||||
5 | coverages or other contributory coverages on
behalf of its | ||||||
6 | employees, adjusted for differences between State | ||||||
7 | employees and
employees of the domestic violence shelter or | ||||||
8 | service in age, sex, geographic
location or other relevant | ||||||
9 | demographic variables, plus an amount sufficient
to pay for | ||||||
10 | the additional administrative costs of providing coverage | ||||||
11 | to
employees of the domestic violence shelter or service | ||||||
12 | and their dependents.
| ||||||
13 | (2) In subsequent years, a further adjustment shall be | ||||||
14 | made to reflect
the actual prior years' claims experience | ||||||
15 | of the employees of the domestic
violence shelter or | ||||||
16 | service.
| ||||||
17 | Monthly payments by the domestic violence shelter or | ||||||
18 | service or its employees
for group health insurance shall be | ||||||
19 | deposited in the Local Government Health
Insurance Reserve | ||||||
20 | Fund.
| ||||||
21 | (k-5) Any qualified small business within the
State of | ||||||
22 | Illinois may apply to the Director to have its employees, | ||||||
23 | annuitants,
and their dependents provided group health | ||||||
24 | coverage under this Act on a
non-insured basis. The Department | ||||||
25 | may set a limit on the number of qualified
small businesses | ||||||
26 | that may receive group health
coverage under this subsection |
| |||||||
| |||||||
1 | (k-5). In order to control its costs, the
Department may | ||||||
2 | designate which plans it will offer to qualified small
| ||||||
3 | businesses under this subsection (k-5). Those plans
may
| ||||||
4 | include, but need not be limited to, minimum, limited, or | ||||||
5 | comprehensive
coverage plans; Health Maintenance Organization | ||||||
6 | and Preferred Provider
Organization plans; and medical savings | ||||||
7 | plans.
The plans may include the utilization of insurance | ||||||
8 | producers in the
marketing of coverage under the plans.
In | ||||||
9 | offering
plans under this subsection (k-5) the Department shall | ||||||
10 | be subject to ratings
and minimum coverage in the same manner | ||||||
11 | as a private insurer.
Any plan offered under this subsection | ||||||
12 | (k-5) may provide for employee
contributions to the cost of the | ||||||
13 | plan.
A qualified
small business may select one or more of the | ||||||
14 | plans
offered by the Department to offer to its employees. To | ||||||
15 | participate, a
qualified small business must agree to offer to | ||||||
16 | enroll
all of its employees and remit the entire cost of | ||||||
17 | providing such coverage for
its
employees, except that the | ||||||
18 | qualified small business shall not be required to
enroll
those
| ||||||
19 | of its employees who waive coverage under this subsection (k-5) | ||||||
20 | because
they are covered spouses or dependents under another | ||||||
21 | group policy or plan
providing health benefits as long as (1) | ||||||
22 | an appropriate official from the
qualified small business | ||||||
23 | attests that each employee not enrolled is a covered
spouse or | ||||||
24 | dependent under another group policy or plan and (2) at least | ||||||
25 | 75%
of the remaining employees are enrolled. A participating | ||||||
26 | qualified small
business
may also elect to cover its |
| |||||||
| |||||||
1 | annuitants. Dependent coverage shall be offered on
an optional | ||||||
2 | basis, with the costs paid by the
small
business, its | ||||||
3 | employees, or some combination of the 2 as determined by the
| ||||||
4 | qualified small business. The qualified small business
shall be | ||||||
5 | responsible for timely collection and
transmission of all | ||||||
6 | premiums.
| ||||||
7 | The Director shall annually determine rates of payment | ||||||
8 | taking into
consideration, among other things, the
following:
| ||||||
9 | (1) In the first year of coverage, the rates shall be | ||||||
10 | equal to the
amount normally charged to State employees for | ||||||
11 | elected optional coverages
or for enrolled dependents | ||||||
12 | coverages or other contributory coverages on
behalf of its | ||||||
13 | employees, adjusted for differences between State | ||||||
14 | employees and
employees of the
qualified small business
in | ||||||
15 | age, sex, geographic
location or other relevant | ||||||
16 | demographic variables, plus an amount sufficient
to pay for | ||||||
17 | the additional administrative costs of providing coverage | ||||||
18 | to
employees of the
qualified small business
and their | ||||||
19 | dependents.
| ||||||
20 | (2) In subsequent years, a further adjustment shall be | ||||||
21 | made to reflect
the actual prior years' claims experience | ||||||
22 | of the employees of the
qualified small business.
| ||||||
23 | Monthly payments by the
qualified small business
for group | ||||||
24 | health insurance shall be deposited into the Small Employers | ||||||
25 | Health
Insurance Reserve Fund. The Small Employers Health
| ||||||
26 | Insurance Reserve Fund shall be a continuing fund not subject |
| |||||||
| |||||||
1 | to fiscal year
limitations. All expenditures from this fund | ||||||
2 | shall be used for payments for
health care benefits for | ||||||
3 | employees of qualified small
businesses and their annuitants | ||||||
4 | and dependents and to reimburse the Department
or its | ||||||
5 | administrative service organization for all expenses incurred | ||||||
6 | in the
administration of benefits. No State funds, other than | ||||||
7 | those specifically
appropriated, may be used for these
| ||||||
8 | purposes. | ||||||
9 | (l) A public community college or entity organized pursuant | ||||||
10 | to the
Public Community College Act may apply to the Director | ||||||
11 | initially to have
only annuitants not covered prior to July 1, | ||||||
12 | 1992 by the district's health
plan provided health coverage | ||||||
13 | under this Act on a non-insured basis. The
community college | ||||||
14 | must execute a 2-year contract to participate in the
Local | ||||||
15 | Government Health Plan.
Any annuitant may enroll in the event | ||||||
16 | of a qualifying change in status, special
enrollment, special | ||||||
17 | circumstance as defined by the Director, or during the
annual | ||||||
18 | Benefit Choice Period.
| ||||||
19 | The Director shall annually determine monthly rates of | ||||||
20 | payment subject to
the following constraints: for those | ||||||
21 | community colleges with annuitants
only enrolled, first year | ||||||
22 | rates shall be equal to the average cost to cover
claims for a | ||||||
23 | State member adjusted for demographics, Medicare
| ||||||
24 | participation, and other factors; and in the second year, a | ||||||
25 | further adjustment
of rates shall be made to reflect the actual | ||||||
26 | first year's claims experience
of the covered annuitants.
|
| |||||||
| |||||||
1 | (l-5) The provisions of subsection (l) become inoperative | ||||||
2 | on July 1, 1999.
| ||||||
3 | (m) The Director shall adopt any rules deemed necessary for
| ||||||
4 | implementation of this amendatory Act of 1989 (Public Act | ||||||
5 | 86-978).
| ||||||
6 | (n) Any child advocacy center within the State of Illinois | ||||||
7 | may apply to the Director to have its employees, annuitants, | ||||||
8 | and their dependents provided group health coverage under this | ||||||
9 | Act on a non-insured basis. To participate, a child advocacy | ||||||
10 | center must agree to enroll all of its employees and pay the | ||||||
11 | entire cost of providing coverage for its employees. A | ||||||
12 | participating child advocacy center may also elect to cover its | ||||||
13 | annuitants. Dependent coverage shall be offered on an optional | ||||||
14 | basis, with the costs paid by the child advocacy center, its | ||||||
15 | employees, or some combination of the 2 as determined by the | ||||||
16 | child advocacy center. The child advocacy center shall be | ||||||
17 | responsible for timely collection and transmission of | ||||||
18 | dependent premiums. | ||||||
19 | The Director shall annually determine rates of payment, | ||||||
20 | subject to the following constraints: | ||||||
21 | (1) In the first year of coverage, the rates shall be | ||||||
22 | equal to the amount normally charged to State employees for | ||||||
23 | elected optional coverages or for enrolled dependents | ||||||
24 | coverages or other contributory coverages on behalf of its | ||||||
25 | employees, adjusted for differences between State | ||||||
26 | employees and employees of the child advocacy center in |
| |||||||
| |||||||
1 | age, sex, geographic location, or other relevant | ||||||
2 | demographic variables, plus an amount sufficient to pay for | ||||||
3 | the additional administrative costs of providing coverage | ||||||
4 | to employees of the child advocacy center and their | ||||||
5 | dependents. | ||||||
6 | (2) In subsequent years, a further adjustment shall be | ||||||
7 | made to reflect the actual prior years' claims experience | ||||||
8 | of the employees of the child advocacy center. | ||||||
9 | Monthly payments by the child advocacy center or its | ||||||
10 | employees for group health insurance shall be deposited into | ||||||
11 | the Local Government Health Insurance Reserve Fund. | ||||||
12 | (Source: P.A. 94-839, eff. 6-6-06; 94-860, eff. 6-16-06; | ||||||
13 | 95-331, eff. 8-21-07; 95-632, eff. 9-25-07; 95-707, eff. | ||||||
14 | 1-11-08.)
| ||||||
15 | (5 ILCS 375/13.2)
(from Ch. 127, par. 533.2)
| ||||||
16 | Sec. 13.2. Insurance reserve funds; investments. All | ||||||
17 | amounts held in
the Health Insurance Reserve Fund, the Group | ||||||
18 | Insurance Premium Fund, the
Small Employers Health Insurance | ||||||
19 | Reserve Fund, and
the Local Government Health
Insurance Reserve | ||||||
20 | Fund shall be invested, at interest, by the State
Treasurer. | ||||||
21 | The investments shall be subject to terms, conditions, and
| ||||||
22 | limitations imposed by the laws of Illinois on State funds. All | ||||||
23 | income
derived from the investments shall accrue and be | ||||||
24 | deposited to the
respective funds no less frequently than | ||||||
25 | quarterly. The Health Insurance
Reserve Fund , the Small |
| |||||||
| |||||||
1 | Employers Health Insurance Reserve Fund, and the
Local | ||||||
2 | Government Health Insurance Reserve Fund shall
be administered | ||||||
3 | by the Director.
| ||||||
4 | (Source: P.A. 91-390, eff. 7-30-99.)
| ||||||
5 | (5 ILCS 375/15) (from Ch. 127, par. 535)
| ||||||
6 | Sec. 15. Administration; rules; audit; review.
| ||||||
7 | (a) The Director shall administer this Act and shall | ||||||
8 | prescribe
such rules and regulations as are necessary to give | ||||||
9 | full effect to the
purposes of this Act.
| ||||||
10 | (b) These rules may fix reasonable standards for the group | ||||||
11 | life and
group health programs and other benefit programs | ||||||
12 | offered under this
Act, and for the contractors providing them.
| ||||||
13 | (c) These rules shall specify that covered and optional | ||||||
14 | medical
services of the program are services provided within | ||||||
15 | the scope of their
licenses by practitioners in all categories | ||||||
16 | licensed under the Medical
Practice Act of 1987 and shall | ||||||
17 | provide that all eligible persons be
fully informed of this | ||||||
18 | specification.
| ||||||
19 | (d) These rules shall establish eligibility requirements | ||||||
20 | for
members and dependents as may be necessary to supplement
or | ||||||
21 | clarify requirements contained in this Act.
| ||||||
22 | (e) Each affected department of the State, the State | ||||||
23 | Universities
Retirement System, the Teachers' Retirement | ||||||
24 | System, and each qualified local
government, rehabilitation | ||||||
25 | facility, domestic violence shelter or service, small |
| |||||||
| |||||||
1 | business,
or child advocacy center, shall keep such records, | ||||||
2 | make such certifications, and furnish the Director
such | ||||||
3 | information as may be necessary for the administration of this | ||||||
4 | Act,
including information concerning number and total amounts | ||||||
5 | of payroll of
employees of the department who are paid from | ||||||
6 | trust funds or federal funds.
| ||||||
7 | (f) Each member, each community college benefit recipient | ||||||
8 | to whom this Act
applies, and each TRS benefit recipient to | ||||||
9 | whom this Act applies shall
furnish the Director, in such form | ||||||
10 | as may be required, any
information that may be necessary to | ||||||
11 | enroll such member
or benefit recipient and, if applicable, his | ||||||
12 | or her
dependents or dependent beneficiaries under the programs | ||||||
13 | or
plan, including such data as may be required to allow the | ||||||
14 | Director to
accumulate statistics on data normally considered | ||||||
15 | in actuarial studies of
employee groups. Information about | ||||||
16 | community college benefit recipients and
community college | ||||||
17 | dependent beneficiaries shall be furnished through the State
| ||||||
18 | Universities Retirement System. Information about TRS benefit | ||||||
19 | recipients and
TRS dependent beneficiaries shall be furnished | ||||||
20 | through the Teachers' Retirement
System.
| ||||||
21 | (g) There shall be audits and reports
on the programs | ||||||
22 | authorized and established by this Act prepared by the Director
| ||||||
23 | with the assistance of a qualified, independent accounting | ||||||
24 | firm. The
reports shall provide information on the experience, | ||||||
25 | and
administrative effectiveness
and adequacy of the program | ||||||
26 | including, when applicable, recommendations on
up-grading of |
| |||||||
| |||||||
1 | benefits and improvement of the program.
| ||||||
2 | (h) Any final order, decision or other determination made, | ||||||
3 | issued or
executed by the Director under the provisions of this | ||||||
4 | Act whereby any
contractor or person is aggrieved shall be | ||||||
5 | subject to review in accordance
with the provisions of the | ||||||
6 | Administrative Review Law and all amendments
and modifications | ||||||
7 | thereof, and the rules adopted pursuant thereto, shall
apply to | ||||||
8 | and govern all proceedings for the judicial review of final
| ||||||
9 | administrative decisions of the Director.
| ||||||
10 | (Source: P.A. 94-860, eff. 6-16-06.)
| ||||||
11 | Section 10. The State Finance Act is amended by changing
| ||||||
12 | Section 25 as follows:
| ||||||
13 | (30 ILCS 105/25) (from Ch. 127, par. 161)
| ||||||
14 | Sec. 25. Fiscal year limitations.
| ||||||
15 | (a) All appropriations shall be
available for expenditure | ||||||
16 | for the fiscal year or for a lesser period if the
Act making | ||||||
17 | that appropriation so specifies. A deficiency or emergency
| ||||||
18 | appropriation shall be available for expenditure only through | ||||||
19 | June 30 of
the year when the Act making that appropriation is | ||||||
20 | enacted unless that Act
otherwise provides.
| ||||||
21 | (b) Outstanding liabilities as of June 30, payable from | ||||||
22 | appropriations
which have otherwise expired, may be paid out of | ||||||
23 | the expiring
appropriations during the 2-month period ending at | ||||||
24 | the
close of business on August 31. Any service involving
|
| |||||||
| |||||||
1 | professional or artistic skills or any personal services by an | ||||||
2 | employee whose
compensation is subject to income tax | ||||||
3 | withholding must be performed as of June
30 of the fiscal year | ||||||
4 | in order to be considered an "outstanding liability as of
June | ||||||
5 | 30" that is thereby eligible for payment out of the expiring
| ||||||
6 | appropriation.
| ||||||
7 | However, payment of tuition reimbursement claims under | ||||||
8 | Section 14-7.03 or
18-3 of the School Code may be made by the | ||||||
9 | State Board of Education from its
appropriations for those | ||||||
10 | respective purposes for any fiscal year, even though
the claims | ||||||
11 | reimbursed by the payment may be claims attributable to a prior
| ||||||
12 | fiscal year, and payments may be made at the direction of the | ||||||
13 | State
Superintendent of Education from the fund from which the | ||||||
14 | appropriation is made
without regard to any fiscal year | ||||||
15 | limitations.
| ||||||
16 | Medical payments may be made by the Department of Veterans' | ||||||
17 | Affairs from
its
appropriations for those purposes for any | ||||||
18 | fiscal year, without regard to the
fact that the medical | ||||||
19 | services being compensated for by such payment may have
been | ||||||
20 | rendered in a prior fiscal year.
| ||||||
21 | Medical payments may be made by the Department of | ||||||
22 | Healthcare and Family Services and medical payments and child | ||||||
23 | care
payments may be made by the Department of
Human Services | ||||||
24 | (as successor to the Department of Public Aid) from
| ||||||
25 | appropriations for those purposes for any fiscal year,
without | ||||||
26 | regard to the fact that the medical or child care services |
| |||||||
| |||||||
1 | being
compensated for by such payment may have been rendered in | ||||||
2 | a prior fiscal
year; and payments may be made at the direction | ||||||
3 | of the Department of
Central Management Services from the | ||||||
4 | Health Insurance Reserve Fund , the Small
Employers Health | ||||||
5 | Insurance Reserve Fund, and the
Local Government Health | ||||||
6 | Insurance Reserve Fund without regard to any fiscal
year | ||||||
7 | limitations.
| ||||||
8 | Medical payments may be made by the Department of Human | ||||||
9 | Services from its appropriations relating to substance abuse | ||||||
10 | treatment services for any fiscal year, without regard to the | ||||||
11 | fact that the medical services being compensated for by such | ||||||
12 | payment may have been rendered in a prior fiscal year, provided | ||||||
13 | the payments are made on a fee-for-service basis consistent | ||||||
14 | with requirements established for Medicaid reimbursement by | ||||||
15 | the Department of Healthcare and Family Services. | ||||||
16 | Additionally, payments may be made by the Department of | ||||||
17 | Human Services from
its appropriations, or any other State | ||||||
18 | agency from its appropriations with
the approval of the | ||||||
19 | Department of Human Services, from the Immigration Reform
and | ||||||
20 | Control Fund for purposes authorized pursuant to the | ||||||
21 | Immigration Reform
and Control Act of 1986, without regard to | ||||||
22 | any fiscal year limitations.
| ||||||
23 | Further, with respect to costs incurred in fiscal years | ||||||
24 | 2002 and 2003 only,
payments may be made by the State Treasurer | ||||||
25 | from its
appropriations
from the Capital Litigation Trust Fund | ||||||
26 | without regard to any fiscal year
limitations.
|
| |||||||
| |||||||
1 | Lease payments may be made by the Department of Central | ||||||
2 | Management
Services under the sale and leaseback provisions of
| ||||||
3 | Section 7.4 of
the State Property Control Act with respect to | ||||||
4 | the James R. Thompson Center and
the
Elgin Mental Health Center | ||||||
5 | and surrounding land from appropriations for that
purpose | ||||||
6 | without regard to any fiscal year
limitations.
| ||||||
7 | Lease payments may be made under the sale and leaseback | ||||||
8 | provisions of
Section 7.5 of the State Property Control Act | ||||||
9 | with
respect to the
Illinois State Toll Highway Authority | ||||||
10 | headquarters building and surrounding
land
without regard to | ||||||
11 | any fiscal year
limitations.
| ||||||
12 | (c) Further, payments may be made by the Department of | ||||||
13 | Public Health and the
Department of Human Services (acting as | ||||||
14 | successor to the Department of Public
Health under the | ||||||
15 | Department of Human Services Act)
from their respective | ||||||
16 | appropriations for grants for medical care to or on
behalf of | ||||||
17 | persons
suffering from chronic renal disease, persons | ||||||
18 | suffering from hemophilia, rape
victims, and premature and | ||||||
19 | high-mortality risk infants and their mothers and
for grants | ||||||
20 | for supplemental food supplies provided under the United States
| ||||||
21 | Department of Agriculture Women, Infants and Children | ||||||
22 | Nutrition Program,
for any fiscal year without regard to the | ||||||
23 | fact that the services being
compensated for by such payment | ||||||
24 | may have been rendered in a prior fiscal year.
| ||||||
25 | (d) The Department of Public Health and the Department of | ||||||
26 | Human Services
(acting as successor to the Department of Public |
| |||||||
| |||||||
1 | Health under the Department of
Human Services Act) shall each | ||||||
2 | annually submit to the State Comptroller, Senate
President, | ||||||
3 | Senate
Minority Leader, Speaker of the House, House Minority | ||||||
4 | Leader, and the
respective Chairmen and Minority Spokesmen of | ||||||
5 | the
Appropriations Committees of the Senate and the House, on | ||||||
6 | or before
December 31, a report of fiscal year funds used to | ||||||
7 | pay for services
provided in any prior fiscal year. This report | ||||||
8 | shall document by program or
service category those | ||||||
9 | expenditures from the most recently completed fiscal
year used | ||||||
10 | to pay for services provided in prior fiscal years.
| ||||||
11 | (e) The Department of Healthcare and Family Services, the | ||||||
12 | Department of Human Services
(acting as successor to the | ||||||
13 | Department of Public Aid), and the Department of Human Services | ||||||
14 | making fee-for-service payments relating to substance abuse | ||||||
15 | treatment services provided during a previous fiscal year shall | ||||||
16 | each annually
submit to the State
Comptroller, Senate | ||||||
17 | President, Senate Minority Leader, Speaker of the House,
House | ||||||
18 | Minority Leader, the respective Chairmen and Minority | ||||||
19 | Spokesmen of the
Appropriations Committees of the Senate and | ||||||
20 | the House, on or before November
30, a report that shall | ||||||
21 | document by program or service category those
expenditures from | ||||||
22 | the most recently completed fiscal year used to pay for (i)
| ||||||
23 | services provided in prior fiscal years and (ii) services for | ||||||
24 | which claims were
received in prior fiscal years.
| ||||||
25 | (f) The Department of Human Services (as successor to the | ||||||
26 | Department of
Public Aid) shall annually submit to the State
|
| |||||||
| |||||||
1 | Comptroller, Senate President, Senate Minority Leader, Speaker | ||||||
2 | of the House,
House Minority Leader, and the respective | ||||||
3 | Chairmen and Minority Spokesmen of
the Appropriations | ||||||
4 | Committees of the Senate and the House, on or before
December | ||||||
5 | 31, a report
of fiscal year funds used to pay for services | ||||||
6 | (other than medical care)
provided in any prior fiscal year. | ||||||
7 | This report shall document by program or
service category those | ||||||
8 | expenditures from the most recently completed fiscal
year used | ||||||
9 | to pay for services provided in prior fiscal years.
| ||||||
10 | (g) In addition, each annual report required to be | ||||||
11 | submitted by the
Department of Healthcare and Family Services | ||||||
12 | under subsection (e) shall include the following
information | ||||||
13 | with respect to the State's Medicaid program:
| ||||||
14 | (1) Explanations of the exact causes of the variance | ||||||
15 | between the previous
year's estimated and actual | ||||||
16 | liabilities.
| ||||||
17 | (2) Factors affecting the Department of Healthcare and | ||||||
18 | Family Services' liabilities,
including but not limited to | ||||||
19 | numbers of aid recipients, levels of medical
service | ||||||
20 | utilization by aid recipients, and inflation in the cost of | ||||||
21 | medical
services.
| ||||||
22 | (3) The results of the Department's efforts to combat | ||||||
23 | fraud and abuse.
| ||||||
24 | (h) As provided in Section 4 of the General Assembly | ||||||
25 | Compensation Act,
any utility bill for service provided to a | ||||||
26 | General Assembly
member's district office for a period |
| |||||||
| |||||||
1 | including portions of 2 consecutive
fiscal years may be paid | ||||||
2 | from funds appropriated for such expenditure in
either fiscal | ||||||
3 | year.
| ||||||
4 | (i) An agency which administers a fund classified by the | ||||||
5 | Comptroller as an
internal service fund may issue rules for:
| ||||||
6 | (1) billing user agencies in advance for payments or | ||||||
7 | authorized inter-fund transfers
based on estimated charges | ||||||
8 | for goods or services;
| ||||||
9 | (2) issuing credits, refunding through inter-fund | ||||||
10 | transfers, or reducing future inter-fund transfers
during
| ||||||
11 | the subsequent fiscal year for all user agency payments or | ||||||
12 | authorized inter-fund transfers received during the
prior | ||||||
13 | fiscal year which were in excess of the final amounts owed | ||||||
14 | by the user
agency for that period; and
| ||||||
15 | (3) issuing catch-up billings to user agencies
during | ||||||
16 | the subsequent fiscal year for amounts remaining due when | ||||||
17 | payments or authorized inter-fund transfers
received from | ||||||
18 | the user agency during the prior fiscal year were less than | ||||||
19 | the
total amount owed for that period.
| ||||||
20 | User agencies are authorized to reimburse internal service | ||||||
21 | funds for catch-up
billings by vouchers drawn against their | ||||||
22 | respective appropriations for the
fiscal year in which the | ||||||
23 | catch-up billing was issued or by increasing an authorized | ||||||
24 | inter-fund transfer during the current fiscal year. For the | ||||||
25 | purposes of this Act, "inter-fund transfers" means transfers | ||||||
26 | without the use of the voucher-warrant process, as authorized |
| |||||||
| |||||||
1 | by Section 9.01 of the State Comptroller Act.
| ||||||
2 | (Source: P.A. 95-331, eff. 8-21-07.)
|