100TH GENERAL ASSEMBLY
State of Illinois
2017 and 2018
SB2292

 

Introduced 1/10/2018, by Sen. Tim Bivins

 

SYNOPSIS AS INTRODUCED:
 
5 ILCS 375/9  from Ch. 127, par. 529
5 ILCS 375/10  from Ch. 127, par. 530

    Amends the State Employees Group Insurance Act of 1971. Provides that any member of the General Assembly sworn into office on and after the second Wednesday in January of 2019, and who retires a participating member under the General Assembly Retirement System, shall be responsible for exactly 50% of the applicable premiums, charges, or other fees for the basic program of group health benefits. Provides that, subject to a reduction based upon Medicare coverage, the State's contribution towards the basic program of group health benefits for such General Assembly members shall be exactly 50% of the applicable premiums, charges, or other fees owed. Provides that the provisions requiring 50% contribution for retired General Assembly member health benefits do not apply to any person who previously served as a member of the General Assembly in either house prior to the second Wednesday of January of 2019. Makes conforming changes. Effective immediately.


LRB100 16179 RJF 31300 b

FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

SB2292LRB100 16179 RJF 31300 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 9 and 10 as follows:
 
6    (5 ILCS 375/9)  (from Ch. 127, par. 529)
7    Sec. 9. (a) The eligible member shall be responsible for
8his or her portion of the premiums, charges or other fees for
9all elected coverages or benefits, which shall be paid by means
10of the acceptance of a reduction in earnings or the foregoing
11of an increase in earnings by an employee; provided, however,
12subject to rules and regulations promulgated by the Department,
13the eligible member may make personal payment of the premium,
14charge or fee for any wellness programs implemented under the
15program of health benefits. All contributions and payments by
16the eligible members and the State for all elected coverages
17and benefits shall be deposited in the Health Insurance Reserve
18Fund. Except as otherwise provided in subsection (a-5), the The
19Department may determine the aggregate level of contribution
20required under this Section on the basis of actual cost of
21services adjusted for age, sex or the geographical or other
22demographic characteristics which affect costs of the benefit.
23    (a-5) Notwithstanding any provision of law to the contrary,

 

 

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1any member of the General Assembly sworn into office on and
2after the second Wednesday in January of 2019, and who retires
3a participating member under Article 2 of the Illinois Pension
4Code, shall be responsible for exactly 50% of the applicable
5premiums, charges, or other fees for the basic program of group
6health benefits. The provisions of this subsection (a-5) do not
7apply to any person who previously served as a member of the
8General Assembly in either house prior to the second Wednesday
9of January of 2019.
10    (b) If a member is not entitled to receive any salary,
11wages or other compensation during a period in which premiums,
12charges or other fees are due or does not receive compensation
13sufficient to allow deduction of the required payment of the
14premium, charge or other fee, such member may continue the
15contributory benefit in effect by making personal payment of
16the premium, charge or other fee for the period in such manner,
17in such amount, and for such duration, as may be prescribed in
18rules and regulations promulgated for the administration of
19this Act.
20(Source: P.A. 91-390, eff. 7-30-99.)
 
21    (5 ILCS 375/10)  (from Ch. 127, par. 530)
22    Sec. 10. Contributions by the State and members.
23    (a) The State shall pay the cost of basic non-contributory
24group life insurance and, subject to member paid contributions
25set by the Department or required by this Section and except as

 

 

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1provided in this Section, the basic program of group health
2benefits on each eligible member, except a member, not
3otherwise covered by this Act, who has retired as a
4participating member under Article 2 of the Illinois Pension
5Code but is ineligible for the retirement annuity under Section
62-119 of the Illinois Pension Code, and part of each eligible
7member's and retired member's premiums for health insurance
8coverage for enrolled dependents as provided by Section 9. The
9State shall pay the cost of the basic program of group health
10benefits only after benefits are reduced by the amount of
11benefits covered by Medicare for all members and dependents who
12are eligible for benefits under Social Security or the Railroad
13Retirement system or who had sufficient Medicare-covered
14government employment, except that such reduction in benefits
15shall apply only to those members and dependents who (1) first
16become eligible for such Medicare coverage on or after July 1,
171992; or (2) are Medicare-eligible members or dependents of a
18local government unit which began participation in the program
19on or after July 1, 1992; or (3) remain eligible for, but no
20longer receive Medicare coverage which they had been receiving
21on or after July 1, 1992. The Department may determine the
22aggregate level of the State's contribution on the basis of
23actual cost of medical services adjusted for age, sex or
24geographic or other demographic characteristics which affect
25the costs of such programs, except that, subject to a reduction
26based upon Medicare coverage, the State's contribution towards

 

 

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1the basic program of group health benefits provided to members
2specified under subsection (a-5) of Section 9 shall be exactly
350% of the applicable premiums, charges, or other fees owed.
4    The cost of participation in the basic program of group
5health benefits for the dependent or survivor of a living or
6deceased retired employee who was formerly employed by the
7University of Illinois in the Cooperative Extension Service and
8would be an annuitant but for the fact that he or she was made
9ineligible to participate in the State Universities Retirement
10System by clause (4) of subsection (a) of Section 15-107 of the
11Illinois Pension Code shall not be greater than the cost of
12participation that would otherwise apply to that dependent or
13survivor if he or she were the dependent or survivor of an
14annuitant under the State Universities Retirement System.
15    (a-1) (Blank).
16    (a-2) (Blank).
17    (a-3) (Blank).
18    (a-4) (Blank).
19    (a-5) (Blank).
20    (a-6) (Blank).
21    (a-7) (Blank).
22    (a-8) Any annuitant, survivor, or retired employee may
23waive or terminate coverage in the program of group health
24benefits. Any such annuitant, survivor, or retired employee who
25has waived or terminated coverage may enroll or re-enroll in
26the program of group health benefits only during the annual

 

 

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1benefit choice period, as determined by the Director; except
2that in the event of termination of coverage due to nonpayment
3of premiums, the annuitant, survivor, or retired employee may
4not re-enroll in the program.
5    (a-8.5) Beginning on the effective date of this amendatory
6Act of the 97th General Assembly, and except as otherwise
7provided under subsection (a) of this Section and subsection
8(a-5) of Section 9, the Director of Central Management Services
9shall, on an annual basis, determine the amount that the State
10shall contribute toward the basic program of group health
11benefits on behalf of annuitants (including individuals who (i)
12participated in the General Assembly Retirement System, the
13State Employees' Retirement System of Illinois, the State
14Universities Retirement System, the Teachers' Retirement
15System of the State of Illinois, or the Judges Retirement
16System of Illinois and (ii) qualify as annuitants under
17subsection (b) of Section 3 of this Act), survivors (including
18individuals who (i) receive an annuity as a survivor of an
19individual who participated in the General Assembly Retirement
20System, the State Employees' Retirement System of Illinois, the
21State Universities Retirement System, the Teachers' Retirement
22System of the State of Illinois, or the Judges Retirement
23System of Illinois and (ii) qualify as survivors under
24subsection (q) of Section 3 of this Act), and retired employees
25(as defined in subsection (p) of Section 3 of this Act). The
26remainder of the cost of coverage for each annuitant, survivor,

 

 

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1or retired employee, as determined by the Director of Central
2Management Services, shall be the responsibility of that
3annuitant, survivor, or retired employee.
4    Contributions required of annuitants, survivors, and
5retired employees shall be the same for all retirement systems
6and shall also be based on whether an individual has made an
7election under Section 15-135.1 of the Illinois Pension Code.
8Contributions may be based on annuitants', survivors', or
9retired employees' Medicare eligibility, but may not be based
10on Social Security eligibility.
11    (a-9) No later than May 1 of each calendar year, the
12Director of Central Management Services shall certify in
13writing to the Executive Secretary of the State Employees'
14Retirement System of Illinois the amounts of the Medicare
15supplement health care premiums and the amounts of the health
16care premiums for all other retirees who are not Medicare
17eligible.
18    A separate calculation of the premiums based upon the
19actual cost of each health care plan shall be so certified.
20    The Director of Central Management Services shall provide
21to the Executive Secretary of the State Employees' Retirement
22System of Illinois such information, statistics, and other data
23as he or she may require to review the premium amounts
24certified by the Director of Central Management Services.
25    The Department of Central Management Services, or any
26successor agency designated to procure healthcare contracts

 

 

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1pursuant to this Act, is authorized to establish funds,
2separate accounts provided by any bank or banks as defined by
3the Illinois Banking Act, or separate accounts provided by any
4savings and loan association or associations as defined by the
5Illinois Savings and Loan Act of 1985 to be held by the
6Director, outside the State treasury, for the purpose of
7receiving the transfer of moneys from the Local Government
8Health Insurance Reserve Fund. The Department may promulgate
9rules further defining the methodology for the transfers. Any
10interest earned by moneys in the funds or accounts shall inure
11to the Local Government Health Insurance Reserve Fund. The
12transferred moneys, and interest accrued thereon, shall be used
13exclusively for transfers to administrative service
14organizations or their financial institutions for payments of
15claims to claimants and providers under the self-insurance
16health plan. The transferred moneys, and interest accrued
17thereon, shall not be used for any other purpose including, but
18not limited to, reimbursement of administration fees due the
19administrative service organization pursuant to its contract
20or contracts with the Department.
21    (b) State employees who become eligible for this program on
22or after January 1, 1980 in positions normally requiring actual
23performance of duty not less than 1/2 of a normal work period
24but not equal to that of a normal work period, shall be given
25the option of participating in the available program. If the
26employee elects coverage, the State shall contribute on behalf

 

 

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1of such employee to the cost of the employee's benefit and any
2applicable dependent supplement, that sum which bears the same
3percentage as that percentage of time the employee regularly
4works when compared to normal work period.
5    (c) The basic non-contributory coverage from the basic
6program of group health benefits shall be continued for each
7employee not in pay status or on active service by reason of
8(1) leave of absence due to illness or injury, (2) authorized
9educational leave of absence or sabbatical leave, or (3)
10military leave. This coverage shall continue until expiration
11of authorized leave and return to active service, but not to
12exceed 24 months for leaves under item (1) or (2). This
1324-month limitation and the requirement of returning to active
14service shall not apply to persons receiving ordinary or
15accidental disability benefits or retirement benefits through
16the appropriate State retirement system or benefits under the
17Workers' Compensation or Occupational Disease Act.
18    (d) The basic group life insurance coverage shall continue,
19with full State contribution, where such person is (1) absent
20from active service by reason of disability arising from any
21cause other than self-inflicted, (2) on authorized educational
22leave of absence or sabbatical leave, or (3) on military leave.
23    (e) Where the person is in non-pay status for a period in
24excess of 30 days or on leave of absence, other than by reason
25of disability, educational or sabbatical leave, or military
26leave, such person may continue coverage only by making

 

 

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1personal payment equal to the amount normally contributed by
2the State on such person's behalf. Such payments and coverage
3may be continued: (1) until such time as the person returns to
4a status eligible for coverage at State expense, but not to
5exceed 24 months or (2) until such person's employment or
6annuitant status with the State is terminated (exclusive of any
7additional service imposed pursuant to law).
8    (f) The Department shall establish by rule the extent to
9which other employee benefits will continue for persons in
10non-pay status or who are not in active service.
11    (g) The State shall not pay the cost of the basic
12non-contributory group life insurance, program of health
13benefits and other employee benefits for members who are
14survivors as defined by paragraphs (1) and (2) of subsection
15(q) of Section 3 of this Act. The costs of benefits for these
16survivors shall be paid by the survivors or by the University
17of Illinois Cooperative Extension Service, or any combination
18thereof. However, the State shall pay the amount of the
19reduction in the cost of participation, if any, resulting from
20the amendment to subsection (a) made by this amendatory Act of
21the 91st General Assembly.
22    (h) Those persons occupying positions with any department
23as a result of emergency appointments pursuant to Section 8b.8
24of the Personnel Code who are not considered employees under
25this Act shall be given the option of participating in the
26programs of group life insurance, health benefits and other

 

 

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1employee benefits. Such persons electing coverage may
2participate only by making payment equal to the amount normally
3contributed by the State for similarly situated employees. Such
4amounts shall be determined by the Director. Such payments and
5coverage may be continued until such time as the person becomes
6an employee pursuant to this Act or such person's appointment
7is terminated.
8    (i) Any unit of local government within the State of
9Illinois may apply to the Director to have its employees,
10annuitants, and their dependents provided group health
11coverage under this Act on a non-insured basis. To participate,
12a unit of local government must agree to enroll all of its
13employees, who may select coverage under either the State group
14health benefits plan or a health maintenance organization that
15has contracted with the State to be available as a health care
16provider for employees as defined in this Act. A unit of local
17government must remit the entire cost of providing coverage
18under the State group health benefits plan or, for coverage
19under a health maintenance organization, an amount determined
20by the Director based on an analysis of the sex, age,
21geographic location, or other relevant demographic variables
22for its employees, except that the unit of local government
23shall not be required to enroll those of its employees who are
24covered spouses or dependents under this plan or another group
25policy or plan providing health benefits as long as (1) an
26appropriate official from the unit of local government attests

 

 

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1that each employee not enrolled is a covered spouse or
2dependent under this plan or another group policy or plan, and
3(2) at least 50% of the employees are enrolled and the unit of
4local government remits the entire cost of providing coverage
5to those employees, except that a participating school district
6must have enrolled at least 50% of its full-time employees who
7have not waived coverage under the district's group health plan
8by participating in a component of the district's cafeteria
9plan. A participating school district is not required to enroll
10a full-time employee who has waived coverage under the
11district's health plan, provided that an appropriate official
12from the participating school district attests that the
13full-time employee has waived coverage by participating in a
14component of the district's cafeteria plan. For the purposes of
15this subsection, "participating school district" includes a
16unit of local government whose primary purpose is education as
17defined by the Department's rules.
18    Employees of a participating unit of local government who
19are not enrolled due to coverage under another group health
20policy or plan may enroll in the event of a qualifying change
21in status, special enrollment, special circumstance as defined
22by the Director, or during the annual Benefit Choice Period. A
23participating unit of local government may also elect to cover
24its annuitants. Dependent coverage shall be offered on an
25optional basis, with the costs paid by the unit of local
26government, its employees, or some combination of the two as

 

 

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1determined by the unit of local government. The unit of local
2government shall be responsible for timely collection and
3transmission of dependent premiums.
4    The Director shall annually determine monthly rates of
5payment, subject to the following constraints:
6        (1) In the first year of coverage, the rates shall be
7    equal to the amount normally charged to State employees for
8    elected optional coverages or for enrolled dependents
9    coverages or other contributory coverages, or contributed
10    by the State for basic insurance coverages on behalf of its
11    employees, adjusted for differences between State
12    employees and employees of the local government in age,
13    sex, geographic location or other relevant demographic
14    variables, plus an amount sufficient to pay for the
15    additional administrative costs of providing coverage to
16    employees of the unit of local government and their
17    dependents.
18        (2) In subsequent years, a further adjustment shall be
19    made to reflect the actual prior years' claims experience
20    of the employees of the unit of local government.
21    In the case of coverage of local government employees under
22a health maintenance organization, the Director shall annually
23determine for each participating unit of local government the
24maximum monthly amount the unit may contribute toward that
25coverage, based on an analysis of (i) the age, sex, geographic
26location, and other relevant demographic variables of the

 

 

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1unit's employees and (ii) the cost to cover those employees
2under the State group health benefits plan. The Director may
3similarly determine the maximum monthly amount each unit of
4local government may contribute toward coverage of its
5employees' dependents under a health maintenance organization.
6    Monthly payments by the unit of local government or its
7employees for group health benefits plan or health maintenance
8organization coverage shall be deposited in the Local
9Government Health Insurance Reserve Fund.
10    The Local Government Health Insurance Reserve Fund is
11hereby created as a nonappropriated trust fund to be held
12outside the State Treasury, with the State Treasurer as
13custodian. The Local Government Health Insurance Reserve Fund
14shall be a continuing fund not subject to fiscal year
15limitations. The Local Government Health Insurance Reserve
16Fund is not subject to administrative charges or charge-backs,
17including but not limited to those authorized under Section 8h
18of the State Finance Act. All revenues arising from the
19administration of the health benefits program established
20under this Section shall be deposited into the Local Government
21Health Insurance Reserve Fund. Any interest earned on moneys in
22the Local Government Health Insurance Reserve Fund shall be
23deposited into the Fund. All expenditures from this Fund shall
24be used for payments for health care benefits for local
25government and rehabilitation facility employees, annuitants,
26and dependents, and to reimburse the Department or its

 

 

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1administrative service organization for all expenses incurred
2in the administration of benefits. No other State funds may be
3used for these purposes.
4    A local government employer's participation or desire to
5participate in a program created under this subsection shall
6not limit that employer's duty to bargain with the
7representative of any collective bargaining unit of its
8employees.
9    (j) Any rehabilitation facility within the State of
10Illinois may apply to the Director to have its employees,
11annuitants, and their eligible dependents provided group
12health coverage under this Act on a non-insured basis. To
13participate, a rehabilitation facility must agree to enroll all
14of its employees and remit the entire cost of providing such
15coverage for its employees, except that the rehabilitation
16facility shall not be required to enroll those of its employees
17who are covered spouses or dependents under this plan or
18another group policy or plan providing health benefits as long
19as (1) an appropriate official from the rehabilitation facility
20attests that each employee not enrolled is a covered spouse or
21dependent under this plan or another group policy or plan, and
22(2) at least 50% of the employees are enrolled and the
23rehabilitation facility remits the entire cost of providing
24coverage to those employees. Employees of a participating
25rehabilitation facility who are not enrolled due to coverage
26under another group health policy or plan may enroll in the

 

 

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1event of a qualifying change in status, special enrollment,
2special circumstance as defined by the Director, or during the
3annual Benefit Choice Period. A participating rehabilitation
4facility may also elect to cover its annuitants. Dependent
5coverage shall be offered on an optional basis, with the costs
6paid by the rehabilitation facility, its employees, or some
7combination of the 2 as determined by the rehabilitation
8facility. The rehabilitation facility shall be responsible for
9timely collection and transmission of dependent premiums.
10    The Director shall annually determine quarterly rates of
11payment, subject to the following constraints:
12        (1) In the first year of coverage, the rates shall be
13    equal to the amount normally charged to State employees for
14    elected optional coverages or for enrolled dependents
15    coverages or other contributory coverages on behalf of its
16    employees, adjusted for differences between State
17    employees and employees of the rehabilitation facility in
18    age, sex, geographic location or other relevant
19    demographic variables, plus an amount sufficient to pay for
20    the additional administrative costs of providing coverage
21    to employees of the rehabilitation facility and their
22    dependents.
23        (2) In subsequent years, a further adjustment shall be
24    made to reflect the actual prior years' claims experience
25    of the employees of the rehabilitation facility.
26    Monthly payments by the rehabilitation facility or its

 

 

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1employees for group health benefits shall be deposited in the
2Local Government Health Insurance Reserve Fund.
3    (k) Any domestic violence shelter or service within the
4State of Illinois may apply to the Director to have its
5employees, annuitants, and their dependents provided group
6health coverage under this Act on a non-insured basis. To
7participate, a domestic violence shelter or service must agree
8to enroll all of its employees and pay the entire cost of
9providing such coverage for its employees. The domestic
10violence shelter shall not be required to enroll those of its
11employees who are covered spouses or dependents under this plan
12or another group policy or plan providing health benefits as
13long as (1) an appropriate official from the domestic violence
14shelter attests that each employee not enrolled is a covered
15spouse or dependent under this plan or another group policy or
16plan and (2) at least 50% of the employees are enrolled and the
17domestic violence shelter remits the entire cost of providing
18coverage to those employees. Employees of a participating
19domestic violence shelter who are not enrolled due to coverage
20under another group health policy or plan may enroll in the
21event of a qualifying change in status, special enrollment, or
22special circumstance as defined by the Director or during the
23annual Benefit Choice Period. A participating domestic
24violence shelter may also elect to cover its annuitants.
25Dependent coverage shall be offered on an optional basis, with
26employees, or some combination of the 2 as determined by the

 

 

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1domestic violence shelter or service. The domestic violence
2shelter or service shall be responsible for timely collection
3and transmission of dependent premiums.
4    The Director shall annually determine rates of payment,
5subject to the following constraints:
6        (1) In the first year of coverage, the rates shall be
7    equal to the amount normally charged to State employees for
8    elected optional coverages or for enrolled dependents
9    coverages or other contributory coverages on behalf of its
10    employees, adjusted for differences between State
11    employees and employees of the domestic violence shelter or
12    service in age, sex, geographic location or other relevant
13    demographic variables, plus an amount sufficient to pay for
14    the additional administrative costs of providing coverage
15    to employees of the domestic violence shelter or service
16    and their dependents.
17        (2) In subsequent years, a further adjustment shall be
18    made to reflect the actual prior years' claims experience
19    of the employees of the domestic violence shelter or
20    service.
21    Monthly payments by the domestic violence shelter or
22service or its employees for group health insurance shall be
23deposited in the Local Government Health Insurance Reserve
24Fund.
25    (l) A public community college or entity organized pursuant
26to the Public Community College Act may apply to the Director

 

 

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1initially to have only annuitants not covered prior to July 1,
21992 by the district's health plan provided health coverage
3under this Act on a non-insured basis. The community college
4must execute a 2-year contract to participate in the Local
5Government Health Plan. Any annuitant may enroll in the event
6of a qualifying change in status, special enrollment, special
7circumstance as defined by the Director, or during the annual
8Benefit Choice Period.
9    The Director shall annually determine monthly rates of
10payment subject to the following constraints: for those
11community colleges with annuitants only enrolled, first year
12rates shall be equal to the average cost to cover claims for a
13State member adjusted for demographics, Medicare
14participation, and other factors; and in the second year, a
15further adjustment of rates shall be made to reflect the actual
16first year's claims experience of the covered annuitants.
17    (l-5) The provisions of subsection (l) become inoperative
18on July 1, 1999.
19    (m) The Director shall adopt any rules deemed necessary for
20implementation of this amendatory Act of 1989 (Public Act
2186-978).
22    (n) Any child advocacy center within the State of Illinois
23may apply to the Director to have its employees, annuitants,
24and their dependents provided group health coverage under this
25Act on a non-insured basis. To participate, a child advocacy
26center must agree to enroll all of its employees and pay the

 

 

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1entire cost of providing coverage for its employees. The child
2advocacy center shall not be required to enroll those of its
3employees who are covered spouses or dependents under this plan
4or another group policy or plan providing health benefits as
5long as (1) an appropriate official from the child advocacy
6center attests that each employee not enrolled is a covered
7spouse or dependent under this plan or another group policy or
8plan and (2) at least 50% of the employees are enrolled and the
9child advocacy center remits the entire cost of providing
10coverage to those employees. Employees of a participating child
11advocacy center who are not enrolled due to coverage under
12another group health policy or plan may enroll in the event of
13a qualifying change in status, special enrollment, or special
14circumstance as defined by the Director or during the annual
15Benefit Choice Period. A participating child advocacy center
16may also elect to cover its annuitants. Dependent coverage
17shall be offered on an optional basis, with the costs paid by
18the child advocacy center, its employees, or some combination
19of the 2 as determined by the child advocacy center. The child
20advocacy center shall be responsible for timely collection and
21transmission of dependent premiums.
22    The Director shall annually determine rates of payment,
23subject to the following constraints:
24        (1) In the first year of coverage, the rates shall be
25    equal to the amount normally charged to State employees for
26    elected optional coverages or for enrolled dependents

 

 

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1    coverages or other contributory coverages on behalf of its
2    employees, adjusted for differences between State
3    employees and employees of the child advocacy center in
4    age, sex, geographic location, or other relevant
5    demographic variables, plus an amount sufficient to pay for
6    the additional administrative costs of providing coverage
7    to employees of the child advocacy center and their
8    dependents.
9        (2) In subsequent years, a further adjustment shall be
10    made to reflect the actual prior years' claims experience
11    of the employees of the child advocacy center.
12    Monthly payments by the child advocacy center or its
13employees for group health insurance shall be deposited into
14the Local Government Health Insurance Reserve Fund.
15(Source: P.A. 97-695, eff. 7-1-12; 98-488, eff. 8-16-13.)
 
16    Section 99. Effective date. This Act takes effect upon
17becoming law.