100TH GENERAL ASSEMBLY
State of Illinois
2017 and 2018
SB1317

 

Introduced 2/9/2017, by Sen. Scott M. Bennett

 

SYNOPSIS AS INTRODUCED:
 
5 ILCS 375/3  from Ch. 127, par. 523
5 ILCS 375/8  from Ch. 127, par. 528

     Amends the State Employees Group Insurance Act of 1971. Modifies the term "annuitant" to not include any member of the General Assembly, or the surviving spouse of such a person, who is sworn into office for the first time on or after the effective date of this amendatory Act, and retires as a participating member under the General Assembly Retirement System, for the purpose of administering health benefits under the Act. Provides that eligible members who are members of the General Assembly before the effective date of this amendatory Act may, upon or during retirement from the General Assembly, make an irrevocable election not to participate in the program of health benefits as defined in this Act. Provides that any election not to participate in the program of health benefits made by a member prior to this amendatory Act shall not be considered irrevocable. Provides that the election to not participate must be made during the annual benefit choice period, or upon showing a qualifying change in status, subject to certain specified conditions. Effective immediately.


LRB100 07948 RJF 18022 b

FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

SB1317LRB100 07948 RJF 18022 b

1    AN ACT concerning government.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The State Employees Group Insurance Act of 1971
5is amended by changing Sections 3 and 8 as follows:
 
6    (5 ILCS 375/3)  (from Ch. 127, par. 523)
7    Sec. 3. Definitions. Unless the context otherwise
8requires, the following words and phrases as used in this Act
9shall have the following meanings. The Department may define
10these and other words and phrases separately for the purpose of
11implementing specific programs providing benefits under this
12Act.
13    (a) "Administrative service organization" means any
14person, firm or corporation experienced in the handling of
15claims which is fully qualified, financially sound and capable
16of meeting the service requirements of a contract of
17administration executed with the Department.
18    (b) "Annuitant" means (1) an employee who retires, or has
19retired, on or after January 1, 1966 on an immediate annuity
20under the provisions of Articles 2, 14 (including an employee
21who has elected to receive an alternative retirement
22cancellation payment under Section 14-108.5 of the Illinois
23Pension Code in lieu of an annuity), 15 (including an employee

 

 

SB1317- 2 -LRB100 07948 RJF 18022 b

1who has retired under the optional retirement program
2established under Section 15-158.2), paragraphs (2), (3), or
3(5) of Section 16-106, or Article 18 of the Illinois Pension
4Code; (2) any person who was receiving group insurance coverage
5under this Act as of March 31, 1978 by reason of his status as
6an annuitant, even though the annuity in relation to which such
7coverage was provided is a proportional annuity based on less
8than the minimum period of service required for a retirement
9annuity in the system involved; (3) any person not otherwise
10covered by this Act who has retired as a participating member
11under Article 2 of the Illinois Pension Code but is ineligible
12for the retirement annuity under Section 2-119 of the Illinois
13Pension Code; (4) the spouse of any person who is receiving a
14retirement annuity under Article 18 of the Illinois Pension
15Code and who is covered under a group health insurance program
16sponsored by a governmental employer other than the State of
17Illinois and who has irrevocably elected to waive his or her
18coverage under this Act and to have his or her spouse
19considered as the "annuitant" under this Act and not as a
20"dependent"; or (5) an employee who retires, or has retired,
21from a qualified position, as determined according to rules
22promulgated by the Director, under a qualified local
23government, a qualified rehabilitation facility, a qualified
24domestic violence shelter or service, or a qualified child
25advocacy center. (For definition of "retired employee", see (p)
26post). "Annuitant" does not include any member of the General

 

 

SB1317- 3 -LRB100 07948 RJF 18022 b

1Assembly, or the surviving spouse of such a person, who is
2sworn into office for the first time on or after the effective
3date of this amendatory Act of the 100th General Assembly, and
4retires as a participating member under Article 2 of the
5Illinois Pension Code.
6    (b-5) (Blank).
7    (b-6) (Blank).
8    (b-7) (Blank).
9    (c) "Carrier" means (1) an insurance company, a corporation
10organized under the Limited Health Service Organization Act or
11the Voluntary Health Services Plan Act, a partnership, or other
12nongovernmental organization, which is authorized to do group
13life or group health insurance business in Illinois, or (2) the
14State of Illinois as a self-insurer.
15    (d) "Compensation" means salary or wages payable on a
16regular payroll by the State Treasurer on a warrant of the
17State Comptroller out of any State, trust or federal fund, or
18by the Governor of the State through a disbursing officer of
19the State out of a trust or out of federal funds, or by any
20Department out of State, trust, federal or other funds held by
21the State Treasurer or the Department, to any person for
22personal services currently performed, and ordinary or
23accidental disability benefits under Articles 2, 14, 15
24(including ordinary or accidental disability benefits under
25the optional retirement program established under Section
2615-158.2), paragraphs (2), (3), or (5) of Section 16-106, or

 

 

SB1317- 4 -LRB100 07948 RJF 18022 b

1Article 18 of the Illinois Pension Code, for disability
2incurred after January 1, 1966, or benefits payable under the
3Workers' Compensation or Occupational Diseases Act or benefits
4payable under a sick pay plan established in accordance with
5Section 36 of the State Finance Act. "Compensation" also means
6salary or wages paid to an employee of any qualified local
7government, qualified rehabilitation facility, qualified
8domestic violence shelter or service, or qualified child
9advocacy center.
10    (e) "Commission" means the State Employees Group Insurance
11Advisory Commission authorized by this Act. Commencing July 1,
121984, "Commission" as used in this Act means the Commission on
13Government Forecasting and Accountability as established by
14the Legislative Commission Reorganization Act of 1984.
15    (f) "Contributory", when referred to as contributory
16coverage, shall mean optional coverages or benefits elected by
17the member toward the cost of which such member makes
18contribution, or which are funded in whole or in part through
19the acceptance of a reduction in earnings or the foregoing of
20an increase in earnings by an employee, as distinguished from
21noncontributory coverage or benefits which are paid entirely by
22the State of Illinois without reduction of the member's salary.
23    (g) "Department" means any department, institution, board,
24commission, officer, court or any agency of the State
25government receiving appropriations and having power to
26certify payrolls to the Comptroller authorizing payments of

 

 

SB1317- 5 -LRB100 07948 RJF 18022 b

1salary and wages against such appropriations as are made by the
2General Assembly from any State fund, or against trust funds
3held by the State Treasurer and includes boards of trustees of
4the retirement systems created by Articles 2, 14, 15, 16 and 18
5of the Illinois Pension Code. "Department" also includes the
6Illinois Comprehensive Health Insurance Board, the Board of
7Examiners established under the Illinois Public Accounting
8Act, and the Illinois Finance Authority.
9    (h) "Dependent", when the term is used in the context of
10the health and life plan, means a member's spouse and any child
11(1) from birth to age 26 including an adopted child, a child
12who lives with the member from the time of the filing of a
13petition for adoption until entry of an order of adoption, a
14stepchild or adjudicated child, or a child who lives with the
15member if such member is a court appointed guardian of the
16child or (2) age 19 or over who has a mental or physical
17disability from a cause originating prior to the age of 19 (age
1826 if enrolled as an adult child dependent). For the health
19plan only, the term "dependent" also includes (1) any person
20enrolled prior to the effective date of this Section who is
21dependent upon the member to the extent that the member may
22claim such person as a dependent for income tax deduction
23purposes and (2) any person who has received after June 30,
242000 an organ transplant and who is financially dependent upon
25the member and eligible to be claimed as a dependent for income
26tax purposes. A member requesting to cover any dependent must

 

 

SB1317- 6 -LRB100 07948 RJF 18022 b

1provide documentation as requested by the Department of Central
2Management Services and file with the Department any and all
3forms required by the Department.
4    (i) "Director" means the Director of the Illinois
5Department of Central Management Services.
6    (j) "Eligibility period" means the period of time a member
7has to elect enrollment in programs or to select benefits
8without regard to age, sex or health.
9    (k) "Employee" means and includes each officer or employee
10in the service of a department who (1) receives his
11compensation for service rendered to the department on a
12warrant issued pursuant to a payroll certified by a department
13or on a warrant or check issued and drawn by a department upon
14a trust, federal or other fund or on a warrant issued pursuant
15to a payroll certified by an elected or duly appointed officer
16of the State or who receives payment of the performance of
17personal services on a warrant issued pursuant to a payroll
18certified by a Department and drawn by the Comptroller upon the
19State Treasurer against appropriations made by the General
20Assembly from any fund or against trust funds held by the State
21Treasurer, and (2) is employed full-time or part-time in a
22position normally requiring actual performance of duty during
23not less than 1/2 of a normal work period, as established by
24the Director in cooperation with each department, except that
25persons elected by popular vote will be considered employees
26during the entire term for which they are elected regardless of

 

 

SB1317- 7 -LRB100 07948 RJF 18022 b

1hours devoted to the service of the State, and (3) except that
2"employee" does not include any person who is not eligible by
3reason of such person's employment to participate in one of the
4State retirement systems under Articles 2, 14, 15 (either the
5regular Article 15 system or the optional retirement program
6established under Section 15-158.2) or 18, or under paragraph
7(2), (3), or (5) of Section 16-106, of the Illinois Pension
8Code, but such term does include persons who are employed
9during the 6 month qualifying period under Article 14 of the
10Illinois Pension Code. Such term also includes any person who
11(1) after January 1, 1966, is receiving ordinary or accidental
12disability benefits under Articles 2, 14, 15 (including
13ordinary or accidental disability benefits under the optional
14retirement program established under Section 15-158.2),
15paragraphs (2), (3), or (5) of Section 16-106, or Article 18 of
16the Illinois Pension Code, for disability incurred after
17January 1, 1966, (2) receives total permanent or total
18temporary disability under the Workers' Compensation Act or
19Occupational Disease Act as a result of injuries sustained or
20illness contracted in the course of employment with the State
21of Illinois, or (3) is not otherwise covered under this Act and
22has retired as a participating member under Article 2 of the
23Illinois Pension Code but is ineligible for the retirement
24annuity under Section 2-119 of the Illinois Pension Code.
25However, a person who satisfies the criteria of the foregoing
26definition of "employee" except that such person is made

 

 

SB1317- 8 -LRB100 07948 RJF 18022 b

1ineligible to participate in the State Universities Retirement
2System by clause (4) of subsection (a) of Section 15-107 of the
3Illinois Pension Code is also an "employee" for the purposes of
4this Act. "Employee" also includes any person receiving or
5eligible for benefits under a sick pay plan established in
6accordance with Section 36 of the State Finance Act. "Employee"
7also includes (i) each officer or employee in the service of a
8qualified local government, including persons appointed as
9trustees of sanitary districts regardless of hours devoted to
10the service of the sanitary district, (ii) each employee in the
11service of a qualified rehabilitation facility, (iii) each
12full-time employee in the service of a qualified domestic
13violence shelter or service, and (iv) each full-time employee
14in the service of a qualified child advocacy center, as
15determined according to rules promulgated by the Director.
16    (l) "Member" means an employee, annuitant, retired
17employee or survivor. In the case of an annuitant or retired
18employee who first becomes an annuitant or retired employee on
19or after the effective date of this amendatory Act of the 97th
20General Assembly, the individual must meet the minimum vesting
21requirements of the applicable retirement system in order to be
22eligible for group insurance benefits under that system. In the
23case of a survivor who first becomes a survivor on or after the
24effective date of this amendatory Act of the 97th General
25Assembly, the deceased employee, annuitant, or retired
26employee upon whom the annuity is based must have been eligible

 

 

SB1317- 9 -LRB100 07948 RJF 18022 b

1to participate in the group insurance system under the
2applicable retirement system in order for the survivor to be
3eligible for group insurance benefits under that system.
4    (m) "Optional coverages or benefits" means those coverages
5or benefits available to the member on his or her voluntary
6election, and at his or her own expense.
7    (n) "Program" means the group life insurance, health
8benefits and other employee benefits designed and contracted
9for by the Director under this Act.
10    (o) "Health plan" means a health benefits program offered
11by the State of Illinois for persons eligible for the plan.
12    (p) "Retired employee" means any person who would be an
13annuitant as that term is defined herein but for the fact that
14such person retired prior to January 1, 1966. Such term also
15includes any person formerly employed by the University of
16Illinois in the Cooperative Extension Service who would be an
17annuitant but for the fact that such person was made ineligible
18to participate in the State Universities Retirement System by
19clause (4) of subsection (a) of Section 15-107 of the Illinois
20Pension Code.
21    (q) "Survivor" means a person receiving an annuity as a
22survivor of an employee or of an annuitant. "Survivor" also
23includes: (1) the surviving dependent of a person who satisfies
24the definition of "employee" except that such person is made
25ineligible to participate in the State Universities Retirement
26System by clause (4) of subsection (a) of Section 15-107 of the

 

 

SB1317- 10 -LRB100 07948 RJF 18022 b

1Illinois Pension Code; (2) the surviving dependent of any
2person formerly employed by the University of Illinois in the
3Cooperative Extension Service who would be an annuitant except
4for the fact that such person was made ineligible to
5participate in the State Universities Retirement System by
6clause (4) of subsection (a) of Section 15-107 of the Illinois
7Pension Code; and (3) the surviving dependent of a person who
8was an annuitant under this Act by virtue of receiving an
9alternative retirement cancellation payment under Section
1014-108.5 of the Illinois Pension Code.
11    (q-2) "SERS" means the State Employees' Retirement System
12of Illinois, created under Article 14 of the Illinois Pension
13Code.
14    (q-3) "SURS" means the State Universities Retirement
15System, created under Article 15 of the Illinois Pension Code.
16    (q-4) "TRS" means the Teachers' Retirement System of the
17State of Illinois, created under Article 16 of the Illinois
18Pension Code.
19    (q-5) (Blank).
20    (q-6) (Blank).
21    (q-7) (Blank).
22    (r) "Medical services" means the services provided within
23the scope of their licenses by practitioners in all categories
24licensed under the Medical Practice Act of 1987.
25    (s) "Unit of local government" means any county,
26municipality, township, school district (including a

 

 

SB1317- 11 -LRB100 07948 RJF 18022 b

1combination of school districts under the Intergovernmental
2Cooperation Act), special district or other unit, designated as
3a unit of local government by law, which exercises limited
4governmental powers or powers in respect to limited
5governmental subjects, any not-for-profit association with a
6membership that primarily includes townships and township
7officials, that has duties that include provision of research
8service, dissemination of information, and other acts for the
9purpose of improving township government, and that is funded
10wholly or partly in accordance with Section 85-15 of the
11Township Code; any not-for-profit corporation or association,
12with a membership consisting primarily of municipalities, that
13operates its own utility system, and provides research,
14training, dissemination of information, or other acts to
15promote cooperation between and among municipalities that
16provide utility services and for the advancement of the goals
17and purposes of its membership; the Southern Illinois
18Collegiate Common Market, which is a consortium of higher
19education institutions in Southern Illinois; the Illinois
20Association of Park Districts; and any hospital provider that
21is owned by a county that has 100 or fewer hospital beds and
22has not already joined the program. "Qualified local
23government" means a unit of local government approved by the
24Director and participating in a program created under
25subsection (i) of Section 10 of this Act.
26    (t) "Qualified rehabilitation facility" means any

 

 

SB1317- 12 -LRB100 07948 RJF 18022 b

1not-for-profit organization that is accredited by the
2Commission on Accreditation of Rehabilitation Facilities or
3certified by the Department of Human Services (as successor to
4the Department of Mental Health and Developmental
5Disabilities) to provide services to persons with disabilities
6and which receives funds from the State of Illinois for
7providing those services, approved by the Director and
8participating in a program created under subsection (j) of
9Section 10 of this Act.
10    (u) "Qualified domestic violence shelter or service" means
11any Illinois domestic violence shelter or service and its
12administrative offices funded by the Department of Human
13Services (as successor to the Illinois Department of Public
14Aid), approved by the Director and participating in a program
15created under subsection (k) of Section 10.
16    (v) "TRS benefit recipient" means a person who:
17        (1) is not a "member" as defined in this Section; and
18        (2) is receiving a monthly benefit or retirement
19    annuity under Article 16 of the Illinois Pension Code; and
20        (3) either (i) has at least 8 years of creditable
21    service under Article 16 of the Illinois Pension Code, or
22    (ii) was enrolled in the health insurance program offered
23    under that Article on January 1, 1996, or (iii) is the
24    survivor of a benefit recipient who had at least 8 years of
25    creditable service under Article 16 of the Illinois Pension
26    Code or was enrolled in the health insurance program

 

 

SB1317- 13 -LRB100 07948 RJF 18022 b

1    offered under that Article on the effective date of this
2    amendatory Act of 1995, or (iv) is a recipient or survivor
3    of a recipient of a disability benefit under Article 16 of
4    the Illinois Pension Code.
5    (w) "TRS dependent beneficiary" means a person who:
6        (1) is not a "member" or "dependent" as defined in this
7    Section; and
8        (2) is a TRS benefit recipient's: (A) spouse, (B)
9    dependent parent who is receiving at least half of his or
10    her support from the TRS benefit recipient, or (C) natural,
11    step, adjudicated, or adopted child who is (i) under age
12    26, (ii) was, on January 1, 1996, participating as a
13    dependent beneficiary in the health insurance program
14    offered under Article 16 of the Illinois Pension Code, or
15    (iii) age 19 or over who has a mental or physical
16    disability from a cause originating prior to the age of 19
17    (age 26 if enrolled as an adult child).
18    "TRS dependent beneficiary" does not include, as indicated
19under paragraph (2) of this subsection (w), a dependent of the
20survivor of a TRS benefit recipient who first becomes a
21dependent of a survivor of a TRS benefit recipient on or after
22the effective date of this amendatory Act of the 97th General
23Assembly unless that dependent would have been eligible for
24coverage as a dependent of the deceased TRS benefit recipient
25upon whom the survivor benefit is based.
26    (x) "Military leave" refers to individuals in basic

 

 

SB1317- 14 -LRB100 07948 RJF 18022 b

1training for reserves, special/advanced training, annual
2training, emergency call up, activation by the President of the
3United States, or any other training or duty in service to the
4United States Armed Forces.
5    (y) (Blank).
6    (z) "Community college benefit recipient" means a person
7who:
8        (1) is not a "member" as defined in this Section; and
9        (2) is receiving a monthly survivor's annuity or
10    retirement annuity under Article 15 of the Illinois Pension
11    Code; and
12        (3) either (i) was a full-time employee of a community
13    college district or an association of community college
14    boards created under the Public Community College Act
15    (other than an employee whose last employer under Article
16    15 of the Illinois Pension Code was a community college
17    district subject to Article VII of the Public Community
18    College Act) and was eligible to participate in a group
19    health benefit plan as an employee during the time of
20    employment with a community college district (other than a
21    community college district subject to Article VII of the
22    Public Community College Act) or an association of
23    community college boards, or (ii) is the survivor of a
24    person described in item (i).
25    (aa) "Community college dependent beneficiary" means a
26person who:

 

 

SB1317- 15 -LRB100 07948 RJF 18022 b

1        (1) is not a "member" or "dependent" as defined in this
2    Section; and
3        (2) is a community college benefit recipient's: (A)
4    spouse, (B) dependent parent who is receiving at least half
5    of his or her support from the community college benefit
6    recipient, or (C) natural, step, adjudicated, or adopted
7    child who is (i) under age 26, or (ii) age 19 or over and
8    has a mental or physical disability from a cause
9    originating prior to the age of 19 (age 26 if enrolled as
10    an adult child).
11    "Community college dependent beneficiary" does not
12include, as indicated under paragraph (2) of this subsection
13(aa), a dependent of the survivor of a community college
14benefit recipient who first becomes a dependent of a survivor
15of a community college benefit recipient on or after the
16effective date of this amendatory Act of the 97th General
17Assembly unless that dependent would have been eligible for
18coverage as a dependent of the deceased community college
19benefit recipient upon whom the survivor annuity is based.
20    (bb) "Qualified child advocacy center" means any Illinois
21child advocacy center and its administrative offices funded by
22the Department of Children and Family Services, as defined by
23the Children's Advocacy Center Act (55 ILCS 80/), approved by
24the Director and participating in a program created under
25subsection (n) of Section 10.
26(Source: P.A. 98-488, eff. 8-16-13; 99-143, eff. 7-27-15.)
 

 

 

SB1317- 16 -LRB100 07948 RJF 18022 b

1    (5 ILCS 375/8)  (from Ch. 127, par. 528)
2    Sec. 8. Eligibility.
3    (a) Each employee eligible under the provisions of this Act
4and any rules and regulations promulgated and adopted hereunder
5by the Director shall become immediately eligible and covered
6for all benefits available under the programs. Employees
7electing coverage for eligible dependents shall have the
8coverage effective immediately, provided that the election is
9properly filed in accordance with required filing dates and
10procedures specified by the Director, including the completion
11and submission of all documentation and forms required by the
12Director.
13        (1) Every member originally eligible to elect
14    dependent coverage, but not electing it during the original
15    eligibility period, may subsequently obtain dependent
16    coverage only in the event of a qualifying change in
17    status, special enrollment, special circumstance as
18    defined by the Director, or during the annual Benefit
19    Choice Period.
20        (2) Members described above being transferred from
21    previous coverage towards which the State has been
22    contributing shall be transferred regardless of
23    preexisting conditions, waiting periods, or other
24    requirements that might jeopardize claim payments to which
25    they would otherwise have been entitled.

 

 

SB1317- 17 -LRB100 07948 RJF 18022 b

1        (3) Eligible and covered members that are eligible for
2    coverage as dependents except for the fact of being members
3    shall be transferred to, and covered under, dependent
4    status regardless of preexisting conditions, waiting
5    periods, or other requirements that might jeopardize claim
6    payments to which they would otherwise have been entitled
7    upon cessation of member status and the election of
8    dependent coverage by a member eligible to elect that
9    coverage.
10    (b) New employees shall be immediately insured for the
11basic group life insurance and covered by the program of health
12benefits on the first day of active State service. Optional
13life insurance coverage one to 4 times the basic amount, if
14elected during the relevant eligibility period, will become
15effective on the date of employment. Optional life insurance
16coverage exceeding 4 times the basic amount and all life
17insurance amounts applied for after the eligibility period will
18be effective, subject to satisfactory evidence of insurability
19when applicable, or other necessary qualifications, pursuant
20to the requirements of the applicable benefit program, unless
21there is a change in status that would confer new eligibility
22for change of enrollment under rules established supplementing
23this Act, in which event application must be made within the
24new eligibility period.
25    (c) As to the group health benefits program contracted to
26begin or continue after June 30, 1973, each annuitant,

 

 

SB1317- 18 -LRB100 07948 RJF 18022 b

1survivor, and retired employee shall become immediately
2eligible for all benefits available under that program. Each
3annuitant, survivor, and retired employee shall have coverage
4effective immediately, provided that the election is properly
5filed in accordance with the required filing dates and
6procedures specified by the Director, including the completion
7and submission of all documentation and forms required by the
8Director. Annuitants, survivors, and retired employees may
9elect coverage for eligible dependents and shall have the
10coverage effective immediately, provided that the election is
11properly filed in accordance with required filing dates and
12procedures specified by the Director, except that, for a
13survivor, the dependent sought to be added on or after the
14effective date of this amendatory Act of the 97th General
15Assembly must have been eligible for coverage as a dependent
16under the deceased member upon whom the survivor's annuity is
17based in order to be eligible for coverage under the survivor.
18    Except as otherwise provided in this Act, where husband and
19wife are both eligible members, each shall be enrolled as a
20member and coverage on their eligible dependent children, if
21any, may be under the enrollment and election of either.
22    Regardless of other provisions herein regarding late
23enrollment or other qualifications, as appropriate, the
24Director may periodically authorize open enrollment periods
25for each of the benefit programs at which time each member may
26elect enrollment or change of enrollment without regard to age,

 

 

SB1317- 19 -LRB100 07948 RJF 18022 b

1sex, health, or other qualification under the conditions as may
2be prescribed in rules and regulations supplementing this Act.
3Special open enrollment periods may be declared by the Director
4for certain members only when special circumstances occur that
5affect only those members.
6    (d) Except as provided in subsection (d-3), beginning
7Beginning with fiscal year 2003 and for all subsequent years,
8eligible members may elect not to participate in the program of
9health benefits as defined in this Act. The election must be
10made during the annual benefit choice period, subject to the
11conditions in this subsection.
12        (1) Members must furnish proof of health benefit
13    coverage, either comprehensive major medical coverage or
14    comprehensive managed care plan, from a source other than
15    the Department of Central Management Services in order to
16    elect not to participate in the program.
17        (2) Members may re-enroll in the Department of Central
18    Management Services program of health benefits upon
19    showing a qualifying change in status, as defined in the
20    U.S. Internal Revenue Code, without evidence of
21    insurability and with no limitations on coverage for
22    pre-existing conditions, provided that there was not a
23    break in coverage of more than 63 days.
24        (3) Members may also re-enroll in the program of health
25    benefits during any annual benefit choice period, without
26    evidence of insurability.

 

 

SB1317- 20 -LRB100 07948 RJF 18022 b

1        (4) Members who elect not to participate in the program
2    of health benefits shall be furnished a written explanation
3    of the requirements and limitations for the election not to
4    participate in the program and for re-enrolling in the
5    program. The explanation shall also be included in the
6    annual benefit choice options booklets furnished to
7    members.
8    (d-3) Eligible members who are members of the General
9Assembly before the effective date of this amendatory Act of
10the 100th General Assembly may, upon or during retirement from
11the General Assembly, make an irrevocable election not to
12participate in the program of health benefits as defined in
13this Act, which shall be effective either upon retirement from
14the General Assembly or immediately upon election not to
15participate, whichever is later. Any election not to
16participate in the program of health benefits made by a member
17under subsection (d) prior to this amendatory Act of the 100th
18General Assembly shall not be considered irrevocable. The
19election not to participate under this subsection (d-3) must be
20made during the annual benefit choice period, or upon showing a
21qualifying change in status, as defined in the U.S. Internal
22Revenue Code, subject to the conditions in this subsection
23(d-3).
24        (1) Upon retirement, members must furnish proof of
25    health benefit coverage, either comprehensive major
26    medical coverage, a comprehensive managed care plan, or

 

 

SB1317- 21 -LRB100 07948 RJF 18022 b

1    eligibility for and enrollment in Medicare, from a source
2    other than the Department of Central Management Services in
3    order to elect not to participate in the program.
4        (2) Members who elect not to participate in the program
5    of health benefits shall be furnished a written explanation
6    of the requirements, limitations, and irrevocability for
7    the election not to participate in the program. The
8    explanation shall also be included in the annual benefit
9    choice options booklets or any other comparable means of
10    notification furnished to members.
11    (d-5) Beginning July 1, 2005, the Director may establish a
12program of financial incentives to encourage annuitants
13receiving a retirement annuity, but who are not eligible for
14benefits under the federal Medicare health insurance program
15(Title XVIII of the Social Security Act, as added by Public Law
1689-97) to elect not to participate in the program of health
17benefits provided under this Act. The election by an annuitant
18not to participate under this program must be made in
19accordance with the requirements set forth under subsection
20(d). The financial incentives provided to these annuitants
21under the program may not exceed $150 per month for each
22annuitant electing not to participate in the program of health
23benefits provided under this Act.
24    (d-6) Beginning July 1, 2013, the Director may establish a
25program of financial incentives to encourage annuitants with 20
26or more years of creditable service but who are not eligible

 

 

SB1317- 22 -LRB100 07948 RJF 18022 b

1for benefits under the federal Medicare health insurance
2program (Title XVIII of the Social Security Act, as added by
3Public Law 89-97) to elect not to participate in the program of
4health benefits provided under this Act. The election by an
5annuitant not to participate under this program must be made in
6accordance with the requirements set forth under subsection
7(d). The program established under this subsection (d-6) may
8include a prorated incentive for annuitants with fewer than 20
9years of creditable service, as determined by the Director. The
10financial incentives provided to these annuitants under this
11program may not exceed $500 per month for each annuitant
12electing not to participate in the program of health benefits
13provided under this Act.
14    (e) Notwithstanding any other provision of this Act or the
15rules adopted under this Act, if a person participating in the
16program of health benefits as the dependent spouse of an
17eligible member becomes an annuitant, the person may elect, at
18the time of becoming an annuitant or during any subsequent
19annual benefit choice period, to continue participation as a
20dependent rather than as an eligible member for as long as the
21person continues to be an eligible dependent. In order to be
22eligible to make such an election, the person must have been
23enrolled as a dependent under the program of health benefits
24for no less than one year prior to becoming an annuitant.
25    An eligible member who has elected to participate as a
26dependent may re-enroll in the program of health benefits as an

 

 

SB1317- 23 -LRB100 07948 RJF 18022 b

1eligible member (i) during any subsequent annual benefit choice
2period or (ii) upon showing a qualifying change in status, as
3defined in the U.S. Internal Revenue Code, without evidence of
4insurability and with no limitations on coverage for
5pre-existing conditions.
6    A person who elects to participate in the program of health
7benefits as a dependent rather than as an eligible member shall
8be furnished a written explanation of the consequences of
9electing to participate as a dependent and the conditions and
10procedures for re-enrolling as an eligible member. The
11explanation shall also be included in the annual benefit choice
12options booklet furnished to members.
13(Source: P.A. 97-668, eff. 1-13-12; 98-19, eff. 6-10-13.)
 
14    Section 99. Effective date. This Act takes effect upon
15becoming law.