Full Text of HB4241 96th General Assembly
HB4241enr 96TH GENERAL ASSEMBLY
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HB4241 Enrolled |
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| AN ACT concerning government.
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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 3 and 10 as follows:
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| (5 ILCS 375/3) (from Ch. 127, par. 523)
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| Sec. 3. Definitions. Unless the context otherwise | 8 |
| requires, the
following words and phrases as used in this Act | 9 |
| shall have the following
meanings. The Department may define | 10 |
| these and other words and phrases
separately for the purpose of | 11 |
| implementing specific programs providing benefits
under this | 12 |
| Act.
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| (a) "Administrative service organization" means any | 14 |
| person, firm or
corporation experienced in the handling of | 15 |
| claims which is
fully qualified, financially sound and capable | 16 |
| of meeting the service
requirements of a contract of | 17 |
| administration executed with the Department.
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| (b) "Annuitant" means (1) an employee who retires, or has | 19 |
| retired,
on or after January 1, 1966 on an immediate annuity | 20 |
| under the provisions
of Articles 2, 14 (including an employee | 21 |
| who has elected to receive an alternative retirement | 22 |
| cancellation payment under Section 14-108.5 of the Illinois | 23 |
| Pension Code in lieu of an annuity), 15 (including an employee |
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| who has retired under the optional
retirement program | 2 |
| established under Section 15-158.2),
paragraphs (2), (3), or | 3 |
| (5) of Section 16-106, or
Article 18 of the Illinois Pension | 4 |
| Code; (2) any person who was receiving
group insurance coverage | 5 |
| under this Act as of March 31, 1978 by
reason of his status as | 6 |
| an annuitant, even though the annuity in relation
to which such | 7 |
| coverage was provided is a proportional annuity based on less
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| than the minimum period of service required for a retirement | 9 |
| annuity in
the system involved; (3) any person not otherwise | 10 |
| covered by this Act
who has retired as a participating member | 11 |
| under Article 2 of the Illinois
Pension Code but is ineligible | 12 |
| for the retirement annuity under Section
2-119 of the Illinois | 13 |
| Pension Code; (4) the spouse of any person who
is receiving a | 14 |
| retirement annuity under Article 18 of the Illinois Pension
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| Code and who is covered under a group health insurance program | 16 |
| sponsored
by a governmental employer other than the State of | 17 |
| Illinois and who has
irrevocably elected to waive his or her | 18 |
| coverage under this Act and to have
his or her spouse | 19 |
| considered as the "annuitant" under this Act and not as
a | 20 |
| "dependent"; or (5) an employee who retires, or has retired, | 21 |
| from a
qualified position, as determined according to rules | 22 |
| promulgated by the
Director, under a qualified local | 23 |
| government, a qualified rehabilitation
facility, a qualified | 24 |
| domestic violence shelter or service, or a qualified child | 25 |
| advocacy center. (For definition
of "retired employee", see (p) | 26 |
| post).
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| (b-5) "New SERS annuitant" means a person who, on or after | 2 |
| January 1,
1998, becomes an annuitant, as defined in subsection | 3 |
| (b), by virtue of
beginning to receive a retirement annuity | 4 |
| under Article 14 of the Illinois
Pension Code (including an | 5 |
| employee who has elected to receive an alternative retirement | 6 |
| cancellation payment under Section 14-108.5 of that Code in | 7 |
| lieu of an annuity), and is eligible to participate in the | 8 |
| basic program of group
health benefits provided for annuitants | 9 |
| under this Act.
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| (b-6) "New SURS annuitant" means a person who (1) on or | 11 |
| after January 1,
1998, becomes an annuitant, as defined in | 12 |
| subsection (b), by virtue of
beginning to receive a retirement | 13 |
| annuity under Article 15 of the Illinois
Pension Code, (2) has | 14 |
| not made the election authorized under Section 15-135.1
of the | 15 |
| Illinois Pension Code, and (3) is eligible to participate in | 16 |
| the basic
program of group
health benefits provided for | 17 |
| annuitants under this Act.
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| (b-7) "New TRS State annuitant" means a person who, on or | 19 |
| after July
1, 1998, becomes an annuitant, as defined in | 20 |
| subsection (b), by virtue of
beginning to receive a retirement | 21 |
| annuity under Article 16 of the Illinois
Pension Code based on | 22 |
| service as a teacher as defined in
paragraph (2), (3), or (5) | 23 |
| of Section 16-106 of that Code, and is eligible
to participate | 24 |
| 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 |
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| organized
under the Limited Health Service Organization Act or | 2 |
| the Voluntary Health
Services Plan Act, a partnership, or other | 3 |
| nongovernmental organization,
which is authorized to do group | 4 |
| life or group health insurance business in
Illinois, or (2) the | 5 |
| State of Illinois as a self-insurer.
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| (d) "Compensation" means salary or wages payable on a | 7 |
| regular
payroll by the State Treasurer on a warrant of the | 8 |
| State Comptroller out
of any State, trust or federal fund, or | 9 |
| by the Governor of the State
through a disbursing officer of | 10 |
| the State out of a trust or out of
federal funds, or by any | 11 |
| Department out of State, trust, federal or
other funds held by | 12 |
| the State Treasurer or the Department, to any person
for | 13 |
| personal services currently performed, and ordinary or | 14 |
| accidental
disability benefits under Articles 2, 14, 15 | 15 |
| (including ordinary or accidental
disability benefits under | 16 |
| the optional retirement program established under
Section | 17 |
| 15-158.2), paragraphs (2), (3), or (5) of
Section 16-106, or | 18 |
| Article 18 of the Illinois Pension Code, for disability
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| incurred after January 1, 1966, or benefits payable under the | 20 |
| Workers'
Compensation or Occupational Diseases Act or benefits | 21 |
| payable under a sick
pay plan established in accordance with | 22 |
| Section 36 of the State Finance Act.
"Compensation" also means | 23 |
| salary or wages paid to an employee of any
qualified local | 24 |
| government, qualified rehabilitation facility,
qualified | 25 |
| domestic violence shelter or service, or qualified child | 26 |
| advocacy center.
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| (e) "Commission" means the State Employees Group Insurance | 2 |
| Advisory
Commission authorized by this Act. Commencing July 1, | 3 |
| 1984, "Commission"
as used in this Act means the Commission on | 4 |
| Government Forecasting and Accountability as
established by | 5 |
| the Legislative Commission Reorganization Act of 1984.
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| (f) "Contributory", when referred to as contributory | 7 |
| coverage, shall
mean optional coverages or benefits elected by | 8 |
| the member toward the cost of
which such member makes | 9 |
| contribution, or which are funded in whole or in part
through | 10 |
| the acceptance of a reduction in earnings or the foregoing of | 11 |
| an
increase in earnings by an employee, as distinguished from | 12 |
| noncontributory
coverage or benefits which are paid entirely by | 13 |
| 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 | 16 |
| government
receiving appropriations and having power to | 17 |
| certify payrolls to the
Comptroller authorizing payments of | 18 |
| salary and wages against such
appropriations as are made by the | 19 |
| General Assembly from any State fund, or
against trust funds | 20 |
| held by the State Treasurer and includes boards of
trustees of | 21 |
| the retirement systems created by Articles 2, 14, 15, 16 and
18 | 22 |
| of the Illinois Pension Code. "Department" also includes the | 23 |
| Illinois
Comprehensive Health Insurance Board, the Board of | 24 |
| Examiners established under
the Illinois Public Accounting | 25 |
| Act, and the Illinois Finance Authority.
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| (h) "Dependent", when the term is used in the context of |
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| the health
and life plan, means a member's spouse and any | 2 |
| unmarried child (1) from
birth to age 19 including an adopted | 3 |
| child, a child who lives with the
member from the time of the | 4 |
| filing of a petition for adoption until entry
of an order of | 5 |
| 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 | 7 |
| with the member
if such member is a court appointed guardian of | 8 |
| the child, or (2)
age 19 to 24 23 enrolled as a full-time | 9 |
| student in any accredited school,
financially dependent upon | 10 |
| the member, and eligible to be claimed as a
dependent for | 11 |
| income tax purposes, (2.1) age 19 to 24 on a medical leave of | 12 |
| absence as described in Section 356z.11 of the Illinois | 13 |
| Insurance Code (215 ILCS 5/356z.11), or (3) age 19 or over who | 14 |
| is mentally
or physically handicapped. For the purposes of item | 15 |
| (2), an unmarried child age 19 to 24 23 who is a member of the | 16 |
| United States Armed Services, including the Illinois National | 17 |
| Guard, and is mobilized to active duty shall qualify as a | 18 |
| dependent beyond the age of 24 23 and until the age of 25 and | 19 |
| while a full-time student for the amount of time spent on | 20 |
| active duty between the ages of 19 and 24 23 . The individual | 21 |
| attempting to qualify for this additional time must submit | 22 |
| written documentation of active duty service to the Director. | 23 |
| The changes made by this amendatory Act of the 94th General | 24 |
| Assembly apply only to individuals mobilized to active duty in | 25 |
| the United States Armed Services, including the Illinois | 26 |
| National Guard, on or after January 1, 2002. For
the health |
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| plan only, the term "dependent" also includes any person
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| enrolled prior to the effective date of this Section who is | 3 |
| dependent upon
the member to the extent that the member may | 4 |
| claim such person as a
dependent for income tax deduction | 5 |
| purposes; no other such
person may be enrolled.
For the health | 6 |
| 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 | 8 |
| financially
dependent upon the member and eligible to be | 9 |
| claimed as a dependent for income
tax purposes.
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| (i) "Director" means the Director of the Illinois | 11 |
| Department of Central
Management Services or of any successor | 12 |
| agency designated to administer this Act.
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| (j) "Eligibility period" means the period of time a member | 14 |
| has to
elect enrollment in programs or to select benefits | 15 |
| without regard to
age, sex or health.
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| (k) "Employee" means and includes each officer or employee | 17 |
| in the
service of a department who (1) receives his | 18 |
| compensation for
service rendered to the department on a | 19 |
| warrant issued pursuant to a payroll
certified by a department | 20 |
| or on a warrant or check issued and drawn by a
department upon | 21 |
| a trust, federal or other fund or on a warrant issued
pursuant | 22 |
| 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 | 24 |
| personal
services on a warrant issued pursuant to a payroll | 25 |
| certified by a
Department and drawn by the Comptroller upon the | 26 |
| State Treasurer against
appropriations made by the General |
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| Assembly from any fund or against
trust funds held by the State | 2 |
| Treasurer, and (2) is employed full-time or
part-time in a | 3 |
| position normally requiring actual performance of duty
during | 4 |
| not less than 1/2 of a normal work period, as established by | 5 |
| the
Director in cooperation with each department, except that | 6 |
| persons elected
by popular vote will be considered employees | 7 |
| during the entire
term for which they are elected regardless of | 8 |
| hours devoted to the
service of the State, and (3) except that | 9 |
| "employee" does not include any
person who is not eligible by | 10 |
| reason of such person's employment to
participate in one of the | 11 |
| State retirement systems under Articles 2, 14, 15
(either the | 12 |
| regular Article 15 system or the optional retirement program
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| established under Section 15-158.2) or 18, or under paragraph | 14 |
| (2), (3), or
(5) of Section 16-106, of the Illinois
Pension | 15 |
| Code, but such term does include persons who are employed | 16 |
| during
the 6 month qualifying period under Article 14 of the | 17 |
| Illinois Pension
Code. Such term also includes any person who | 18 |
| (1) after January 1, 1966,
is receiving ordinary or accidental | 19 |
| disability benefits under Articles
2, 14, 15 (including | 20 |
| ordinary or accidental disability benefits under the
optional | 21 |
| retirement program established under Section 15-158.2), | 22 |
| paragraphs
(2), (3), or (5) of Section 16-106, or Article 18 of | 23 |
| the
Illinois Pension Code, for disability incurred after | 24 |
| January 1, 1966, (2)
receives total permanent or total | 25 |
| temporary disability under the Workers'
Compensation Act or | 26 |
| Occupational Disease Act as a result of injuries
sustained or |
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| illness contracted in the course of employment with the
State | 2 |
| of Illinois, or (3) is not otherwise covered under this Act and | 3 |
| has
retired as a participating member under Article 2 of the | 4 |
| Illinois Pension
Code but is ineligible for the retirement | 5 |
| annuity under Section 2-119 of
the Illinois Pension Code. | 6 |
| However, a person who satisfies the criteria
of the foregoing | 7 |
| definition of "employee" except that such person is made
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| ineligible to participate in the State Universities Retirement | 9 |
| System by
clause (4) of subsection (a) of Section 15-107 of the | 10 |
| Illinois Pension
Code is also an "employee" for the purposes of | 11 |
| this Act. "Employee" also
includes any person receiving or | 12 |
| eligible for benefits under a sick pay
plan established in | 13 |
| accordance with Section 36 of the State Finance Act.
"Employee" | 14 |
| also includes (i) each officer or employee in the service of a
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| qualified local government, including persons appointed as | 16 |
| trustees of
sanitary districts regardless of hours devoted to | 17 |
| the service of the
sanitary district, (ii) each employee in the | 18 |
| service of a qualified
rehabilitation facility, (iii) each | 19 |
| full-time employee in the service of a
qualified domestic | 20 |
| violence shelter or service, and (iv) each full-time employee | 21 |
| in the service of a qualified child advocacy center, as | 22 |
| determined according to
rules promulgated by the Director.
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| (l) "Member" means an employee, annuitant, retired | 24 |
| employee or survivor.
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| (m) "Optional coverages or benefits" means those coverages | 26 |
| or
benefits available to the member on his or her voluntary |
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| election, and at
his or her own expense.
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| (n) "Program" means the group life insurance, health | 3 |
| benefits and other
employee benefits designed and contracted | 4 |
| 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 | 8 |
| annuitant as
that term is defined herein but for the fact that | 9 |
| such person retired prior to
January 1, 1966. Such term also | 10 |
| includes any person formerly employed by
the University of | 11 |
| Illinois in the Cooperative Extension Service who would
be an | 12 |
| annuitant but for the fact that such person was made ineligible | 13 |
| to
participate in the State Universities Retirement System by | 14 |
| 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 | 17 |
| survivor of an
employee or of an annuitant. "Survivor" also | 18 |
| includes: (1) the surviving
dependent of a person who satisfies | 19 |
| the definition of "employee" except that
such person is made | 20 |
| ineligible to participate in the State Universities
Retirement | 21 |
| System by clause (4) of subsection (a)
of Section 15-107 of the | 22 |
| Illinois Pension Code; (2) the surviving
dependent of any | 23 |
| person formerly employed by the University of Illinois in
the | 24 |
| Cooperative Extension Service who would be an annuitant except | 25 |
| for the
fact that such person was made ineligible to | 26 |
| participate in the State
Universities Retirement System by |
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| clause (4) of subsection (a) of Section
15-107 of the Illinois | 2 |
| Pension Code; and (3) the surviving dependent of a person who | 3 |
| was an annuitant under this Act by virtue of receiving an | 4 |
| alternative retirement cancellation payment under Section | 5 |
| 14-108.5 of the Illinois Pension Code.
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| (q-2) "SERS" means the State Employees' Retirement System | 7 |
| of Illinois, created under Article 14 of the Illinois Pension | 8 |
| Code.
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| (q-3) "SURS" means the State Universities Retirement | 10 |
| System, created under Article 15 of the Illinois Pension Code.
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| (q-4) "TRS" means the Teachers' Retirement System of the | 12 |
| State of Illinois, created under Article 16 of the Illinois | 13 |
| Pension Code.
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| (q-5) "New SERS survivor" means a survivor, as defined in | 15 |
| subsection (q),
whose annuity is paid under Article 14 of the | 16 |
| Illinois Pension Code and is
based on the death of (i) an | 17 |
| employee whose death occurs on or after January 1,
1998, or | 18 |
| (ii) a new SERS annuitant as defined in subsection (b-5). "New | 19 |
| SERS survivor" includes the surviving dependent of a person who | 20 |
| was an annuitant under this Act by virtue of receiving an | 21 |
| alternative retirement cancellation payment under Section | 22 |
| 14-108.5 of the Illinois Pension Code.
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| (q-6) "New SURS survivor" means a survivor, as defined in | 24 |
| subsection (q),
whose annuity is paid under Article 15 of the | 25 |
| Illinois Pension Code and is
based on the death of (i) an | 26 |
| employee whose death occurs on or after January 1,
1998, or |
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| (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 | 3 |
| in subsection
(q), whose annuity is paid under Article 16 of | 4 |
| the Illinois Pension Code and is
based on the death of (i) an | 5 |
| employee who is a teacher as defined in paragraph
(2), (3), or | 6 |
| (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 | 8 |
| defined in subsection
(b-7).
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| (r) "Medical services" means the services provided within | 10 |
| the scope
of their licenses by practitioners in all categories | 11 |
| licensed under the
Medical Practice Act of 1987.
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| (s) "Unit of local government" means any county, | 13 |
| municipality,
township, school district (including a | 14 |
| combination of school districts under
the Intergovernmental | 15 |
| Cooperation Act), special district or other unit,
designated as | 16 |
| a
unit of local government by law, which exercises limited | 17 |
| governmental
powers or powers in respect to limited | 18 |
| governmental subjects, any
not-for-profit association with a | 19 |
| membership that primarily includes
townships and township | 20 |
| officials, that has duties that include provision of
research | 21 |
| service, dissemination of information, and other acts for the
| 22 |
| purpose of improving township government, and that is funded | 23 |
| wholly or
partly in accordance with Section 85-15 of the | 24 |
| Township Code; any
not-for-profit corporation or association, | 25 |
| with a membership consisting
primarily of municipalities, that | 26 |
| operates its own utility system, and
provides research, |
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| training, dissemination of information, or other acts to
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| promote cooperation between and among municipalities that | 3 |
| provide utility
services and for the advancement of the goals | 4 |
| and purposes of its
membership;
the Southern Illinois | 5 |
| Collegiate Common Market, which is a consortium of higher
| 6 |
| education institutions in Southern Illinois; the Illinois | 7 |
| Association of
Park Districts; and any hospital provider that | 8 |
| is owned by a county that has 100 or fewer hospital beds and | 9 |
| has not already joined the program. "Qualified
local | 10 |
| government" means a unit of local government approved by the | 11 |
| Director and
participating in a program created under | 12 |
| subsection (i) of Section 10 of this
Act.
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| (t) "Qualified rehabilitation facility" means any | 14 |
| not-for-profit
organization that is accredited by the | 15 |
| Commission on Accreditation of
Rehabilitation Facilities or | 16 |
| certified by the Department
of Human Services (as successor to | 17 |
| the Department of Mental Health
and Developmental | 18 |
| Disabilities) to provide services to persons with
disabilities
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| and which receives funds from the State of Illinois for | 20 |
| providing those
services, approved by the Director and | 21 |
| participating in a program created
under subsection (j) of | 22 |
| Section 10 of this Act.
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| (u) "Qualified domestic violence shelter or service" means | 24 |
| any Illinois
domestic violence shelter or service and its | 25 |
| administrative offices funded
by the Department of Human | 26 |
| Services (as successor to the Illinois Department of
Public |
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| Aid),
approved by the Director and
participating in a program | 2 |
| created under subsection (k) of Section 10.
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| (v) "TRS benefit recipient" means a person who:
| 4 |
| (1) is not a "member" as defined in this Section; and
| 5 |
| (2) is receiving a monthly benefit or retirement | 6 |
| annuity
under Article 16 of the Illinois Pension Code; and
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| (3) either (i) has at least 8 years of creditable | 8 |
| service under Article
16 of the Illinois Pension Code, or | 9 |
| (ii) was enrolled in the health insurance
program offered | 10 |
| under that Article on January 1, 1996, or (iii) is the | 11 |
| survivor
of a benefit recipient who had at least 8
years of | 12 |
| creditable service under Article 16 of the Illinois Pension | 13 |
| Code or
was enrolled in the health insurance program | 14 |
| offered under that Article on
the effective date of this | 15 |
| amendatory Act of 1995, or (iv) is a recipient or
survivor | 16 |
| of a recipient of a disability benefit under Article 16 of | 17 |
| the
Illinois Pension Code.
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| (w) "TRS dependent beneficiary" means a person who:
| 19 |
| (1) is not a "member" or "dependent" as defined in this | 20 |
| Section; and
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| (2) is a TRS benefit recipient's: (A) spouse, (B) | 22 |
| dependent parent who
is receiving at least half of his or | 23 |
| her support from the TRS benefit
recipient, or (C) | 24 |
| unmarried natural or adopted child who is (i) under age
19, | 25 |
| or (ii) enrolled as a full-time student in
an accredited | 26 |
| school, financially dependent upon the TRS benefit |
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| recipient,
eligible to be claimed as a dependent for income | 2 |
| tax
purposes, and
either is under age 24 or was, on January | 3 |
| 1, 1996, participating as a dependent
beneficiary in the | 4 |
| health insurance program offered under Article 16 of the
| 5 |
| Illinois Pension Code, or (iii) age 19 or over who is | 6 |
| mentally or physically
handicapped.
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| (x) "Military leave with pay and benefits" refers to | 8 |
| individuals in basic
training for reserves, special/advanced | 9 |
| training, annual training, emergency
call up, or activation by | 10 |
| the President of the United States with approved pay
and | 11 |
| benefits.
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| (y) "Military leave without pay and benefits" refers to
| 13 |
| individuals who enlist for active duty in a regular component | 14 |
| of the U.S. Armed
Forces or other duty not specified or | 15 |
| authorized under military leave with pay
and benefits.
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| (z) "Community college benefit recipient" means a person | 17 |
| who:
| 18 |
| (1) is not a "member" as defined in this Section; and
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| (2) is receiving a monthly survivor's annuity or | 20 |
| retirement annuity
under Article 15 of the Illinois Pension | 21 |
| Code; and
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| (3) either (i) was a full-time employee of a community | 23 |
| college district or
an association of community college | 24 |
| boards created under the Public Community
College Act | 25 |
| (other than an employee whose last employer under Article | 26 |
| 15 of the
Illinois Pension Code was a community college |
|
|
|
HB4241 Enrolled |
- 16 - |
LRB096 03377 JAM 13400 b |
|
| 1 |
| district subject to Article VII
of the Public Community | 2 |
| College Act) and was eligible to participate in a group
| 3 |
| health benefit plan as an employee during the time of | 4 |
| employment with a
community college district (other than a | 5 |
| community college district subject to
Article VII of the | 6 |
| Public Community College Act) or an association of | 7 |
| community
college boards, or (ii) is the survivor of a | 8 |
| person described in item (i).
| 9 |
| (aa) "Community college dependent beneficiary" means a | 10 |
| person who:
| 11 |
| (1) is not a "member" or "dependent" as defined in this | 12 |
| Section; and
| 13 |
| (2) is a community college benefit recipient's: (A) | 14 |
| spouse, (B) dependent
parent who is receiving at least half | 15 |
| of his or her support from the community
college benefit | 16 |
| recipient, or (C) unmarried natural or adopted child who is | 17 |
| (i)
under age 19, or (ii) enrolled as a full-time student | 18 |
| in an accredited school,
financially dependent upon the | 19 |
| community college benefit recipient, eligible
to be | 20 |
| claimed as a dependent for income tax purposes and under | 21 |
| age 23, or (iii)
age 19 or over and mentally or physically | 22 |
| handicapped.
| 23 |
| (bb) "Qualified child advocacy center" means any Illinois | 24 |
| child advocacy center and its administrative offices funded by | 25 |
| the Department of Children and Family Services, as defined by | 26 |
| the Children's Advocacy Center Act (55 ILCS 80/), approved by |
|
|
|
HB4241 Enrolled |
- 17 - |
LRB096 03377 JAM 13400 b |
|
| 1 |
| the Director and participating in a program created under | 2 |
| subsection (n) 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 |
|
|
|
HB4241 Enrolled |
- 18 - |
LRB096 03377 JAM 13400 b |
|
| 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 |
|
|
|
HB4241 Enrolled |
- 19 - |
LRB096 03377 JAM 13400 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 |
|
|
|
HB4241 Enrolled |
- 20 - |
LRB096 03377 JAM 13400 b |
|
| 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 |
|
|
|
HB4241 Enrolled |
- 21 - |
LRB096 03377 JAM 13400 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%;
|
|
|
|
HB4241 Enrolled |
- 22 - |
LRB096 03377 JAM 13400 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.
|
|
|
|
HB4241 Enrolled |
- 23 - |
LRB096 03377 JAM 13400 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 |
|
|
|
HB4241 Enrolled |
- 24 - |
LRB096 03377 JAM 13400 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, |
|
|
|
HB4241 Enrolled |
- 25 - |
LRB096 03377 JAM 13400 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 |
|
|
|
HB4241 Enrolled |
- 26 - |
LRB096 03377 JAM 13400 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 |
|
|
|
HB4241 Enrolled |
- 27 - |
LRB096 03377 JAM 13400 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
50% 85% of the employees are enrolled and the unit | 16 |
| of local government remits
the entire cost of providing | 17 |
| coverage to those employees, except that a
participating school | 18 |
| district must have enrolled at least 50% 85% of its full-time
| 19 |
| employees who have not waived coverage under the district's | 20 |
| group health
plan by participating in a component of the | 21 |
| district's cafeteria plan. A
participating school district is | 22 |
| not required to enroll a full-time employee
who has waived | 23 |
| coverage under the district's health plan, provided that an
| 24 |
| appropriate official from the participating school district | 25 |
| attests that the
full-time employee has waived coverage by | 26 |
| participating in a component of the
district's cafeteria plan. |
|
|
|
HB4241 Enrolled |
- 28 - |
LRB096 03377 JAM 13400 b |
|
| 1 |
| For the purposes of this subsection, "participating
school | 2 |
| district" includes a unit of local government whose primary | 3 |
| purpose is
education as 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 |
|
|
|
HB4241 Enrolled |
- 29 - |
LRB096 03377 JAM 13400 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 |
|
|
|
HB4241 Enrolled |
- 30 - |
LRB096 03377 JAM 13400 b |
|
| 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 and | 8 |
| rehabilitation facility
employees, annuitants, and dependents, | 9 |
| and to reimburse the Department or
its administrative service | 10 |
| organization for all expenses incurred in the
administration of | 11 |
| benefits. No other State funds may be used for these
purposes.
| 12 |
| A local government employer's participation or desire to | 13 |
| participate
in a program created under this subsection shall | 14 |
| not limit that employer's
duty to bargain with the | 15 |
| representative of any collective bargaining unit
of its | 16 |
| employees.
| 17 |
| (j) Any rehabilitation facility within the State of | 18 |
| Illinois may apply
to the Director to have its employees, | 19 |
| annuitants, and their eligible
dependents provided group | 20 |
| health coverage under this Act on a non-insured
basis. To | 21 |
| participate, a rehabilitation facility must agree to enroll all
| 22 |
| of its employees and remit the entire cost of providing such | 23 |
| coverage for
its employees, except that the rehabilitation | 24 |
| facility shall not be
required to enroll those of its employees | 25 |
| who are covered spouses or
dependents under this plan or | 26 |
| another group policy or plan providing health
benefits as long |
|
|
|
HB4241 Enrolled |
- 31 - |
LRB096 03377 JAM 13400 b |
|
| 1 |
| as (1) an appropriate official from the rehabilitation
facility | 2 |
| attests that each employee not enrolled is a covered spouse or
| 3 |
| dependent under this plan or another group policy or plan, and | 4 |
| (2) at least
50% 85% of the employees are enrolled and the | 5 |
| rehabilitation facility remits
the entire cost of providing | 6 |
| coverage to those employees. Employees of a
participating | 7 |
| rehabilitation facility who are not enrolled due to coverage
| 8 |
| under another group health policy or plan may enroll
in the | 9 |
| event of a qualifying change in status, special enrollment, | 10 |
| special
circumstance as defined by the Director, or during the | 11 |
| annual Benefit Choice
Period. A participating rehabilitation | 12 |
| facility may also elect
to cover its annuitants. Dependent | 13 |
| coverage shall be offered on an optional
basis, with the costs | 14 |
| paid by the rehabilitation facility, its employees, or
some | 15 |
| combination of the 2 as determined by the rehabilitation | 16 |
| facility. The
rehabilitation facility shall be responsible for | 17 |
| timely collection and
transmission of dependent premiums.
| 18 |
| The Director shall annually determine quarterly rates of | 19 |
| payment, subject
to the following constraints:
| 20 |
| (1) In the first year of coverage, the rates shall be | 21 |
| equal to the amount
normally charged to State employees for | 22 |
| elected optional coverages or for
enrolled dependents | 23 |
| coverages or other contributory coverages on behalf of
its | 24 |
| employees, adjusted for differences between State | 25 |
| employees and
employees of the rehabilitation facility in | 26 |
| age, sex, geographic location
or other relevant |
|
|
|
HB4241 Enrolled |
- 32 - |
LRB096 03377 JAM 13400 b |
|
| 1 |
| demographic variables, plus an amount sufficient to pay
for | 2 |
| the additional administrative costs of providing coverage | 3 |
| to employees
of the rehabilitation facility and their | 4 |
| dependents.
| 5 |
| (2) In subsequent years, a further adjustment shall be | 6 |
| made to reflect
the actual prior years' claims experience | 7 |
| of the employees of the
rehabilitation facility.
| 8 |
| Monthly payments by the rehabilitation facility or its | 9 |
| employees for
group health benefits shall be deposited in the | 10 |
| Local Government Health
Insurance Reserve Fund.
| 11 |
| (k) Any domestic violence shelter or service within the | 12 |
| State of Illinois
may apply to the Director to have its | 13 |
| employees, annuitants, and their
dependents provided group | 14 |
| health coverage under this Act on a non-insured
basis. To | 15 |
| participate, a domestic violence shelter or service must agree | 16 |
| to
enroll all of its employees and pay the entire cost of | 17 |
| providing such coverage
for its employees. The domestic | 18 |
| violence shelter shall not be required to enroll those of its | 19 |
| employees who are covered spouses or dependents under this plan | 20 |
| or another group policy or plan providing health benefits as | 21 |
| long as (1) an appropriate official from the domestic violence | 22 |
| shelter attests that each employee not enrolled is a covered | 23 |
| spouse or dependent under this plan or another group policy or | 24 |
| plan and (2) at least 50% of the employees are enrolled and the | 25 |
| domestic violence shelter remits the entire cost of providing | 26 |
| coverage to those employees. Employees of a participating |
|
|
|
HB4241 Enrolled |
- 33 - |
LRB096 03377 JAM 13400 b |
|
| 1 |
| domestic violence shelter who are not enrolled due to coverage | 2 |
| under another group health policy or plan may enroll in the | 3 |
| event of a qualifying change in status, special enrollment, or | 4 |
| special circumstance as defined by the Director or during the | 5 |
| annual Benefit Choice Period. A participating domestic | 6 |
| violence shelter may also elect
to cover its annuitants. | 7 |
| Dependent coverage shall be offered on an optional
basis, with
| 8 |
| employees, or some combination of the 2 as determined by the | 9 |
| domestic violence
shelter or service. The domestic violence | 10 |
| shelter or service shall be
responsible for timely collection | 11 |
| and transmission of dependent premiums.
| 12 |
| The Director shall annually determine rates of payment,
| 13 |
| subject to the following constraints:
| 14 |
| (1) In the first year of coverage, the rates shall be | 15 |
| equal to the
amount normally charged to State employees for | 16 |
| elected optional coverages
or for enrolled dependents | 17 |
| coverages or other contributory coverages on
behalf of its | 18 |
| employees, adjusted for differences between State | 19 |
| employees and
employees of the domestic violence shelter or | 20 |
| service in age, sex, geographic
location or other relevant | 21 |
| demographic variables, plus an amount sufficient
to pay for | 22 |
| the additional administrative costs of providing coverage | 23 |
| to
employees of the domestic violence shelter or service | 24 |
| and their dependents.
| 25 |
| (2) In subsequent years, a further adjustment shall be | 26 |
| made to reflect
the actual prior years' claims experience |
|
|
|
HB4241 Enrolled |
- 34 - |
LRB096 03377 JAM 13400 b |
|
| 1 |
| of the employees of the domestic
violence shelter or | 2 |
| service.
| 3 |
| Monthly payments by the domestic violence shelter or | 4 |
| service or its employees
for group health insurance shall be | 5 |
| deposited in the Local Government Health
Insurance Reserve | 6 |
| Fund.
| 7 |
| (l) A public community college or entity organized pursuant | 8 |
| to the
Public Community College Act may apply to the Director | 9 |
| initially to have
only annuitants not covered prior to July 1, | 10 |
| 1992 by the district's health
plan provided health coverage | 11 |
| under this Act on a non-insured basis. The
community college | 12 |
| must execute a 2-year contract to participate in the
Local | 13 |
| Government Health Plan.
Any annuitant may enroll in the event | 14 |
| of a qualifying change in status, special
enrollment, special | 15 |
| circumstance as defined by the Director, or during the
annual | 16 |
| Benefit Choice Period.
| 17 |
| The Director shall annually determine monthly rates of | 18 |
| payment subject to
the following constraints: for those | 19 |
| community colleges with annuitants
only enrolled, first year | 20 |
| rates shall be equal to the average cost to cover
claims for a | 21 |
| State member adjusted for demographics, Medicare
| 22 |
| participation, and other factors; and in the second year, a | 23 |
| further adjustment
of rates shall be made to reflect the actual | 24 |
| first year's claims experience
of the covered annuitants.
| 25 |
| (l-5) The provisions of subsection (l) become inoperative | 26 |
| on July 1, 1999.
|
|
|
|
HB4241 Enrolled |
- 35 - |
LRB096 03377 JAM 13400 b |
|
| 1 |
| (m) The Director shall adopt any rules deemed necessary for
| 2 |
| implementation of this amendatory Act of 1989 (Public Act | 3 |
| 86-978).
| 4 |
| (n) Any child advocacy center within the State of Illinois | 5 |
| may apply to the Director to have its employees, annuitants, | 6 |
| and their dependents provided group health coverage under this | 7 |
| Act on a non-insured basis. To participate, a child advocacy | 8 |
| center must agree to enroll all of its employees and pay the | 9 |
| entire cost of providing coverage for its employees. The child
| 10 |
| advocacy center shall not be required to enroll those of its
| 11 |
| employees who are covered spouses or dependents under this plan
| 12 |
| or another group policy or plan providing health benefits as
| 13 |
| long as (1) an appropriate official from the child advocacy
| 14 |
| center attests that each employee not enrolled is a covered
| 15 |
| spouse or dependent under this plan or another group policy or
| 16 |
| plan and (2) at least 50% of the employees are enrolled and the | 17 |
| child advocacy center remits the entire cost of providing | 18 |
| coverage to those employees. Employees of a participating child | 19 |
| advocacy center who are not enrolled due to coverage under | 20 |
| another group health policy or plan may enroll in the event of | 21 |
| a qualifying change in status, special enrollment, or special | 22 |
| circumstance as defined by the Director or during the annual | 23 |
| Benefit Choice Period. A participating child advocacy center | 24 |
| may also elect to cover its annuitants. Dependent coverage | 25 |
| shall be offered on an optional basis, with the costs paid by | 26 |
| the child advocacy center, its employees, or some combination |
|
|
|
HB4241 Enrolled |
- 36 - |
LRB096 03377 JAM 13400 b |
|
| 1 |
| of the 2 as determined by the child advocacy center. The child | 2 |
| advocacy center shall be responsible for timely collection and | 3 |
| transmission of dependent premiums. | 4 |
| The Director shall annually determine rates of payment, | 5 |
| subject to the following constraints: | 6 |
| (1) In the first year of coverage, the rates shall be | 7 |
| equal to the amount normally charged to State employees for | 8 |
| elected optional coverages or for enrolled dependents | 9 |
| coverages or other contributory coverages on behalf of its | 10 |
| employees, adjusted for differences between State | 11 |
| employees and employees of the child advocacy center in | 12 |
| age, sex, geographic location, or other relevant | 13 |
| demographic variables, plus an amount sufficient to pay for | 14 |
| the additional administrative costs of providing coverage | 15 |
| to employees of the child advocacy center and their | 16 |
| dependents. | 17 |
| (2) In subsequent years, a further adjustment shall be | 18 |
| made to reflect the actual prior years' claims experience | 19 |
| of the employees of the child advocacy center. | 20 |
| Monthly payments by the child advocacy center or its | 21 |
| employees for group health insurance shall be deposited into | 22 |
| the Local Government Health Insurance Reserve Fund. | 23 |
| (Source: P.A. 94-839, eff. 6-6-06; 94-860, eff. 6-16-06; | 24 |
| 95-331, eff. 8-21-07; 95-632, eff. 9-25-07; 95-707, eff. | 25 |
| 1-11-08.)
|
|