Sen. Christine Radogno

Filed: 5/14/2013

 

 


 

 


 
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1
AMENDMENT TO SENATE BILL 1245

2    AMENDMENT NO. ______. Amend Senate Bill 1245, AS AMENDED,
3by replacing everything after the enacting clause with the
4following:
 
5    "Section 5. The Public Safety Employee Benefits Act is
6amended by changing Section 10 as follows:
 
7    (820 ILCS 320/10)
8    Sec. 10. Required health coverage benefits.
9    (a) An employer who employs a full-time law enforcement,
10correctional or correctional probation officer, or firefighter
11(hereinafter referred to as "injured employee"), who, on or
12after the effective date of this Act suffers a catastrophic
13injury or is killed in the line of duty shall pay the entire
14premium of the employer's health insurance plan for the injured
15employee, the injured employee's spouse, and for each dependent
16child of the injured employee until the child reaches the age

 

 

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1of majority or until the end of the calendar year in which the
2child reaches the age of 25 if the child continues to be
3dependent for support or the child is a full-time or part-time
4student and is dependent for support. The term "health
5insurance plan" does not include supplemental benefits that are
6not part of the basic group health insurance plan. If the
7injured employee subsequently dies, the employer shall
8continue to pay the entire health insurance premium for the
9surviving spouse until remarried and for the dependent children
10under the conditions established in this Section. However:
11        (1) Health insurance benefits payable from any other
12    source shall reduce benefits payable under this Section.
13        (2) It is unlawful for a person to willfully and
14    knowingly make, or cause to be made, or to assist, conspire
15    with, or urge another to make, or cause to be made, any
16    false, fraudulent, or misleading oral or written statement
17    to obtain health insurance coverage as provided under this
18    Section. A violation of this item is a Class A misdemeanor.
19        (3) Upon conviction for a violation described in item
20    (2), a law enforcement, correctional or correctional
21    probation officer, or other beneficiary who receives or
22    seeks to receive health insurance benefits under this
23    Section shall forfeit the right to receive health insurance
24    benefits and shall reimburse the employer for all benefits
25    paid due to the fraud or other prohibited activity. For
26    purposes of this item, "conviction" means a determination

 

 

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1    of guilt that is the result of a plea or trial, regardless
2    of whether adjudication is withheld.
3    (b) In order for the law enforcement, correctional or
4correctional probation officer, firefighter, spouse, or
5dependent children to be eligible for insurance coverage under
6this Act, the injury or death must have occurred as the result
7of the officer's response to fresh pursuit, the officer or
8firefighter's response to what is reasonably believed to be an
9emergency, an unlawful act perpetrated by another, or during
10the investigation of a criminal act. Nothing in this Section
11shall be construed to limit health insurance coverage or
12pension benefits for which the officer, firefighter, spouse, or
13dependent children may otherwise be eligible.
14    (c) An injured employee subject to this Act shall be
15required to file a report with his or her employer as
16prescribed in this Section. The Commission on Government
17Forecasting and Accountability (COGFA) shall design the form
18and prescribe the content of the report. Within 60 days after
19the effective date of this amendatory Act of the 98th General
20Assembly, COGFA shall design and remit a copy of this form to
21all employers subject to this Act. The form shall include the
22following:
23        (1) employment by the injured employee within the
24    previous 24-month period;
25        (2) compensation earned by the injured employee as a
26    result of the employment;

 

 

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1        (3) the nature of the injury that entitled the injured
2    employee to a duty disability benefit and benefits as
3    provided under this Act listing the part of the body
4    affected, explaining how it was affected, and including the
5    medical diagnosis, if known;
6        (4) whether the injured employee or his or her spouse
7    has been offered or has access to any insurance from the
8    injured employee's employment or his or her spouse's
9    employment; and
10        (5) whether the injured employee or his or her spouse
11    is currently enrolled in any insurance plan from another
12    source.
13    Within 30 days after receipt of this form, an employer
14shall notify any employee receiving benefits under this Act of
15that employee's obligation to file a report under this Section.
16An employee receiving benefits under this Act must complete and
17return this form to the employer within 30 days of receipt of
18such form. Any employee who has been given notice as provided
19under this Section and who fails to timely file a report under
20this Section within 30 days after receipt of this form shall be
21notified by the employer that he or she has 30 days to submit
22the report or risk losing his or her benefits provided under
23this Act. An employer may suspend premium payments for an
24employee who fails to file this report with the employer 30
25days after receiving this notice. The employee is responsible
26for ensuring that premiums are paid during the period of

 

 

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1suspension. Employers shall return this form to COGFA within 30
2days after receiving the form from the employee.
3    Any information collected by the employer under this
4Section shall be exempt from the requirements of the Freedom of
5Information Act except for data collected in the aggregate that
6does not reveal any personal information concerning the injured
7employee.
8    By July 1 of every odd-numbered year, beginning in 2015,
9employers subject to this Act must send a form to all employees
10eligible for benefits under this Act. The employee must
11complete and return this form by August 1 of that year. Any
12employee who has been given notice as provided under this
13Section and who fails to timely file a completed form under
14this Section within 30 days after receipt of this form shall be
15notified by the employer that he or she has 30 days to submit
16the form or risk losing his or her benefits provided under this
17Act. An employer may suspend premium payments for an employee
18who fails to complete and file this form with the employer 30
19days after receiving this notice. The employee is responsible
20for ensuring that premiums are paid during the period of
21suspension. The employer shall resume premium payments upon
22receipt of the completed form. Employers shall return this form
23to COGFA within 30 days after receiving the form from the
24employee.
25    (d) An employer subject to this Act shall file a claims
26report with COGFA. COGFA shall design the form and prescribe

 

 

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1the content of the report. Within 60 days after the effective
2date of this amendatory Act of the 98th General Assembly, and
3by July 1 of every odd-numbered year thereafter beginning in
42015, COGFA shall remit a copy of this form to all employers
5subject to this Act. An employer covered under this Act shall
6file a copy of this report with COGFA within 120 days after
7receipt of the form.
8    The first claims report filed with COGFA under this Section
9shall set forth all information gathered pursuant to this
10Section and, when available, shall submit the information
11required under this Section for each of the 5 years prior to
12the year in which this amendatory Act of the 98th General
13Assembly became law. All claims reports thereafter shall set
14forth the required information for the 24-month period ending
15on June 30 preceding the deadline date for filing the report.
16The claims report shall, at a minimum, contain the following
17information:
18        (1) the number of claims filed under this Act during
19    the reporting period;
20        (2) the number of claims awarded under this Act during
21    the reporting period;
22        (3) the dollar amount of all claims awarded under this
23    Act during the reporting period;
24        (4) the number of claims paid under this Act during the
25    reporting period regardless of when the claim was awarded;
26        (5) the dollar amount of all claims paid under this Act

 

 

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1    during the reporting period regardless of when the claim
2    was awarded;
3        (6) the annual cost of the benefit and any available
4    long-term cost projections;
5        (7) the nature of the injury as described by the
6    injured employee under item (3) of subsection (c);
7        (8) any employment during the annual reporting period;
8        (9) the compensation earned as a result of that
9    employment; and
10        (10) any offered or accessible insurance options
11    through the injured employee's employment or his or her
12    spouse's employment.
13    The claims report shall redact any information as required
14by the Health Insurance Portability and Accountability Act of
151996 (HIPAA). Any information submitted to COGFA shall not
16reveal any personal information of the injured employee.
17Whenever possible, communication between COGFA and employers
18as required by this Act shall be through electronic means.
19    (e) By June 1, 2014, and by January 1 of every
20even-numbered year thereafter beginning in 2016, COGFA shall
21submit a report to the Governor and General Assembly setting
22forth the information received under subsections (c) and (d).
23The report shall aggregate data in such a way as to not reveal
24the identity of any singular beneficiary. The requirement for
25reporting to the General Assembly shall be satisfied by filing
26copies of the report with the Speaker, Minority Leader, and

 

 

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1Clerk of the House of Representatives, the President, Minority
2Leader, and Secretary of the Senate, the Legislative Research
3Unit as required under Section 3.1 of the General Assembly
4Organization Act, and the State Government Report Distribution
5Center for the General Assembly as required under paragraph (t)
6of Section 7 of the State Library Act. COGFA shall make this
7report available electronically on a publicly accessible
8website.
9(Source: P.A. 90-535, eff. 11-14-97.)
 
10    Section 99. Effective date. This Act takes effect upon
11becoming law.".