093_HB0943enr

 
HB0943 Enrolled                      LRB093 05764 RCE 05857 b

 1        AN ACT in relation to public employee benefits.

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

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

 6        (5 ILCS 375/8) (from Ch. 127, par. 528)
 7        Sec. 8.  Eligibility.
 8        (a)  Each member eligible under the  provisions  of  this
 9    Act  and  any  rules  and regulations promulgated and adopted
10    hereunder by the Director shall become  immediately  eligible
11    and  covered  for  all benefits available under the programs.
12    Members electing coverage for eligible dependents shall  have
13    the   coverage   effective  immediately,  provided  that  the
14    election is properly filed in accordance with required filing
15    dates and procedures specified by the Director.
16             (1)  Every  member  originally  eligible  to   elect
17        dependent  coverage,  but  not  electing  it  during  the
18        original  eligibility  period,  may  subsequently  obtain
19        dependent  coverage  only  in  the  event of a qualifying
20        change   in   status,   special    enrollment,    special
21        circumstance  as  defined  by the Director, or during the
22        annual Benefit Choice Period.
23             (2)  Members described above being transferred  from
24        previous  coverage  towards  which  the  State  has  been
25        contributing   shall   be   transferred   regardless   of
26        preexisting   conditions,   waiting   periods,  or  other
27        requirements that  might  jeopardize  claim  payments  to
28        which they would otherwise have been entitled.
29             (3)  Eligible  and covered members that are eligible
30        for coverage as dependents except for the fact  of  being
31        members  shall  be  transferred  to,  and  covered under,
 
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 1        dependent status regardless  of  preexisting  conditions,
 2        waiting   periods,   or  other  requirements  that  might
 3        jeopardize claim payments to which they  would  otherwise
 4        have  been  entitled  upon cessation of member status and
 5        the election of dependent coverage by a  member  eligible
 6        to elect that coverage.
 7        (b)  New  employees  shall be immediately insured for the
 8    basic group life insurance and  covered  by  the  program  of
 9    health  benefits  on  the  first day of active State service.
10    Optional  coverages  or  benefits,  if  elected  during   the
11    relevant  eligibility  period,  will  become effective on the
12    date of employment.  Optional coverages or  benefits  applied
13    for  after  the eligibility period will be effective, subject
14    to satisfactory evidence of insurability when applicable,  or
15    other  necessary qualifications, pursuant to the requirements
16    of the applicable benefit program, unless there is  a  change
17    in  status  that  would  confer new eligibility for change of
18    enrollment under rules established supplementing this Act, in
19    which  event  application  must  be  made  within   the   new
20    eligibility period.
21        (c)  As  to  the group health benefits program contracted
22    to begin or  continue  after  June  30,  1973,  each  retired
23    employee  shall  become  immediately eligible and covered for
24    all benefits available under that program.  Retired employees
25    may elect coverage for eligible dependents and shall have the
26    coverage effective immediately, provided that the election is
27    properly filed in accordance with required filing  dates  and
28    procedures specified by the Director.
29        Except  as  otherwise provided in this Act, where husband
30    and wife are both eligible members, each shall be enrolled as
31    a member and coverage on their eligible  dependent  children,
32    if any, may be under the enrollment and election of either.
33        Regardless  of  other  provisions  herein  regarding late
34    enrollment  or  other  qualifications,  as  appropriate,  the
 
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 1    Director may periodically authorize open  enrollment  periods
 2    for  each  of  the benefit programs at which time each member
 3    may elect enrollment or change of enrollment  without  regard
 4    to  age,  sex,  health,  or  other  qualification  under  the
 5    conditions  as  may  be  prescribed  in rules and regulations
 6    supplementing this Act.  Special open enrollment periods  may
 7    be  declared  by  the  Director for certain members only when
 8    special circumstances occur that affect only those members.
 9        (d)  Beginning  with  fiscal  year  2003  and   for   all
10    subsequent   years,   eligible   members  may  elect  not  to
11    participate in the program of health benefits as  defined  in
12    this  Act.   The  election  must  be  made  during the annual
13    benefit choice period, subject  to  the  conditions  in  this
14    subsection.
15             (1)  Members  must  furnish  proof of health benefit
16        coverage, either comprehensive major medical coverage  or
17        comprehensive managed care plan, from a source other than
18        the Department of Central Management Services in order to
19        elect not to participate in the program.
20             (2)  Members  may  re-enroll  in  the  Department of
21        Central Management Services program  of  health  benefits
22        upon showing a qualifying change in status, as defined in
23        the  U.S.  Internal  Revenue  Code,  without  evidence of
24        insurability and with  no  limitations  on  coverage  for
25        pre-existing  conditions,  provided  that there was not a
26        break in coverage of more than 63 days.
27             (3)  Members may also re-enroll in  the  program  of
28        health  benefits during any annual benefit choice period,
29        without evidence of insurability.
30             (4)  Members who elect not  to  participate  in  the
31        program  of  health benefits shall be furnished a written
32        explanation of the requirements and limitations  for  the
33        election  not  to  participate  in  the  program  and for
34        re-enrolling in the program. The explanation  shall  also
 
HB0943 Enrolled            -4-       LRB093 05764 RCE 05857 b
 1        be included in the annual benefit choice options booklets
 2        furnished to members.
 3        (e)  Notwithstanding  any  other provision of this Act or
 4    the rules adopted under this Act, if a  person  participating
 5    in  the program of health benefits as the dependent spouse of
 6    an eligible member  becomes  an  annuitant,  the  person  may
 7    elect,  at  the  time  of becoming an annuitant or during any
 8    subsequent  annual  benefit  choice   period,   to   continue
 9    participation  as  a  dependent  rather  than  as an eligible
10    member for as long as the person continues to be an  eligible
11    dependent.
12        An  eligible  member  who has elected to participate as a
13    dependent may re-enroll in the program of health benefits  as
14    an  eligible  member (i) during any subsequent annual benefit
15    choice period or (ii) upon showing  a  qualifying  change  in
16    status, as defined in the U.S. Internal Revenue Code, without
17    evidence  of insurability and with no limitations on coverage
18    for pre-existing conditions.
19        A person who elects to  participate  in  the  program  of
20    health  benefits  as  a  dependent rather than as an eligible
21    member shall  be  furnished  a  written  explanation  of  the
22    consequences  of  electing  to participate as a dependent and
23    the conditions and procedures for re-enrolling as an eligible
24    member.  The explanation shall also be included in the annual
25    benefit choice options booklet furnished to members.
26    (Source: P.A. 91-390, eff. 7-30-99; 92-600, eff. 6-28-02.)

27        Section 99. Effective date.  This Act takes  effect  upon
28    becoming law.