Full Text of HB2408 96th General Assembly
HB2408 96TH GENERAL ASSEMBLY
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96TH GENERAL ASSEMBLY
State of Illinois
2009 and 2010 HB2408
Introduced 2/19/2009, by Rep. Karen May SYNOPSIS AS INTRODUCED: |
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5 ILCS 375/2 |
from Ch. 127, par. 522 |
5 ILCS 375/3 |
from Ch. 127, par. 523 |
5 ILCS 375/10 |
from Ch. 127, par. 530 |
5 ILCS 375/13.2 | from Ch. 127, par. 533.2 |
5 ILCS 375/15 |
from Ch. 127, par. 535 |
30 ILCS 105/25 |
from Ch. 127, par. 161 |
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Amends the State Employees Group Insurance Act of 1971. Provides that small businesses may be provided group health coverage under the Act. Limits small businesses to those with 50 or fewer employees. Specifically allows for payment for coverage by the employees. Provides that employees that have other coverage do not have to enroll in the coverage. Authorizes the use of State funds, pursuant to appropriation, in operating the plan. Provides for the utilization of insurance producers in the marketing of the plans. Makes other changes concerning domestic violence shelters and services. Amends the State Finance Act to provide for payments made on behalf of the small business employees to be deposited into the Small Employers Health Insurance Reserve Fund.
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A BILL FOR
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| AN ACT concerning insurance.
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| Be it enacted by the People of the State of Illinois,
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| represented in the General Assembly:
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| 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:
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| (5 ILCS 375/2) (from Ch. 127, par. 522)
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| 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.
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| (Source: P.A. 94-860, eff. 6-16-06.)
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| (5 ILCS 375/3) (from Ch. 127, par. 523)
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| 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.
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| (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.
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| (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
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| than the minimum period of service required for a retirement |
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| 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
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| 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).
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| (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 |
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| 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.
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| (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.
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| (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
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| annuitants under this Act.
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| (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.
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| (d) "Compensation" means salary or wages payable on a |
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| 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
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| 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.
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| (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.
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| (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.
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| (g) "Department" means any department, institution, board,
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| 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.
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| (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
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| 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
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| 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
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| has received after June 30, 2000 an organ transplant and who is |
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| financially
dependent upon the member and eligible to be | 2 |
| claimed as a dependent for income
tax purposes.
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| (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.
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| (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.
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| (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
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| 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 |
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| 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
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| 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
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| 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
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| 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
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| according to rules promulgated by the
Director.
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| (l) "Member" means an employee, annuitant, retired | 20 |
| employee or survivor.
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| (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.
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| (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.
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| (o) "Health plan" means a health benefits
program offered
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| by the State of Illinois for persons eligible for the plan.
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| (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
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| Pension Code.
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| (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 |
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| 14-108.5 of the Illinois Pension Code.
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| (q-2) "SERS" means the State Employees' Retirement System | 3 |
| of Illinois, created under Article 14 of the Illinois Pension | 4 |
| Code.
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| (q-3) "SURS" means the State Universities Retirement | 6 |
| System, created under Article 15 of the Illinois Pension Code.
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| (q-4) "TRS" means the Teachers' Retirement System of the | 8 |
| State of Illinois, created under Article 16 of the Illinois | 9 |
| Pension Code.
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| (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.
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| (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).
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| (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 |
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| 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
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| after July 1, 1998, or (ii) a new TRS State annuitant as | 4 |
| defined in subsection
(b-7).
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| (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.
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| (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
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| 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 |
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| Collegiate Common Market, which is a consortium of higher
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| 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
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| 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.
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| (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.
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| (v) "TRS benefit recipient" means a person who:
| 26 |
| (1) is not a "member" as defined in this Section; and
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| (2) is receiving a monthly benefit or retirement | 2 |
| annuity
under Article 16 of the Illinois Pension Code; and
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| (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
|
|
|
|
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LRB096 10477 RPM 20649 b |
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| 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 |
|
|
|
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|
| 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 |
|
|
|
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LRB096 10477 RPM 20649 b |
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| 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 |
|
|
|
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LRB096 10477 RPM 20649 b |
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| 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 |
|
|
|
HB2408 |
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LRB096 10477 RPM 20649 b |
|
| 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 |
|
|
|
HB2408 |
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LRB096 10477 RPM 20649 b |
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| 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 |
|
|
|
HB2408 |
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LRB096 10477 RPM 20649 b |
|
| 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%;
|
|
|
|
HB2408 |
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LRB096 10477 RPM 20649 b |
|
| 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.
|
|
|
|
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LRB096 10477 RPM 20649 b |
|
| 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 |
|
|
|
HB2408 |
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LRB096 10477 RPM 20649 b |
|
| 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, |
|
|
|
HB2408 |
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LRB096 10477 RPM 20649 b |
|
| 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 |
|
|
|
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LRB096 10477 RPM 20649 b |
|
| 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 |
|
|
|
HB2408 |
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LRB096 10477 RPM 20649 b |
|
| 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 |
|
|
|
HB2408 |
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LRB096 10477 RPM 20649 b |
|
| 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 |
|
|
|
HB2408 |
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LRB096 10477 RPM 20649 b |
|
| 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 |
|
|
|
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| 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 |
|
|
|
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|
| 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 |
|
|
|
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|
| 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,
|
|
|
|
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|
| 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 |
|
|
|
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| 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 |
|
|
|
HB2408 |
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LRB096 10477 RPM 20649 b |
|
| 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 |
|
|
|
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LRB096 10477 RPM 20649 b |
|
| 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.
|
|
|
|
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LRB096 10477 RPM 20649 b |
|
| 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 |
|
|
|
HB2408 |
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LRB096 10477 RPM 20649 b |
|
| 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 |
|
|
|
HB2408 |
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LRB096 10477 RPM 20649 b |
|
| 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 |
|
|
|
HB2408 |
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LRB096 10477 RPM 20649 b |
|
| 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 |
|
|
|
HB2408 |
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LRB096 10477 RPM 20649 b |
|
| 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
|
|
|
|
HB2408 |
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LRB096 10477 RPM 20649 b |
|
| 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 |
|
|
|
HB2408 |
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LRB096 10477 RPM 20649 b |
|
| 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.
|
|
|
|
HB2408 |
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LRB096 10477 RPM 20649 b |
|
| 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 |
|
|
|
HB2408 |
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LRB096 10477 RPM 20649 b |
|
| 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
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| 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 |
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| 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 |
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| by Section 9.01 of the State Comptroller Act.
| 2 |
| (Source: P.A. 95-331, eff. 8-21-07.)
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