Full Text of HB0450 97th General Assembly
HB0450ham001 97TH GENERAL ASSEMBLY | Rep. Patrick J. Verschoore Filed: 3/10/2011
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| 1 | | AMENDMENT TO HOUSE BILL 450
| 2 | | AMENDMENT NO. ______. Amend House Bill 450 by replacing | 3 | | everything after the enacting clause with the following:
| 4 | | "Section 5. The State Employees Group Insurance Act of 1971 | 5 | | is amended by changing Section 8 as follows:
| 6 | | (5 ILCS 375/8) (from Ch. 127, par. 528)
| 7 | | Sec. 8. Eligibility.
| 8 | | (a) Each member eligible under the provisions of this Act | 9 | | and any rules
and regulations promulgated and adopted hereunder | 10 | | by the Director shall
become immediately eligible and covered | 11 | | for all benefits available under
the programs. Members electing | 12 | | coverage for eligible dependents shall have
the coverage | 13 | | effective immediately, provided that the election is properly
| 14 | | filed in accordance with required filing dates and procedures | 15 | | specified by
the Director.
| 16 | | (1) Every member originally eligible to elect |
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| 1 | | dependent coverage, but not
electing it during the original | 2 | | eligibility period, may subsequently obtain
dependent | 3 | | coverage only in the event of a qualifying change in | 4 | | status, special
enrollment, special circumstance as | 5 | | defined by the Director, or during the
annual Benefit | 6 | | Choice Period.
| 7 | | (2) Members described above being transferred from | 8 | | previous
coverage towards which the State has been | 9 | | contributing shall be
transferred regardless of | 10 | | preexisting conditions, waiting periods, or
other | 11 | | requirements that might jeopardize claim payments to which | 12 | | they
would otherwise have been entitled.
| 13 | | (3) Eligible and covered members that are eligible for | 14 | | coverage as
dependents except for the fact of being members | 15 | | shall be transferred to,
and covered under, dependent | 16 | | status regardless of preexisting conditions,
waiting | 17 | | periods, or other requirements that might jeopardize claim | 18 | | payments
to which they would otherwise have been entitled | 19 | | upon cessation of member
status and the election of | 20 | | dependent coverage by a member eligible to elect
that | 21 | | coverage.
| 22 | | (b) New employees shall be immediately insured for the | 23 | | basic group
life insurance and covered by the program of health | 24 | | benefits on the first
day of active State service. Optional | 25 | | life insurance coverage one to 4 times the basic amount, if | 26 | | elected
during the relevant eligibility period, will become |
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| 1 | | effective on the date
of employment. Optional life insurance | 2 | | coverage exceeding 4 times the basic amount and all life | 3 | | insurance amounts applied for after the
eligibility period will | 4 | | be effective, subject to satisfactory evidence of
insurability | 5 | | when applicable, or other necessary qualifications, pursuant | 6 | | to
the requirements of the applicable benefit program, unless | 7 | | there is a change in
status that would confer new eligibility | 8 | | for change of enrollment under rules
established supplementing | 9 | | this Act, in which event application must be made
within the | 10 | | new eligibility period.
| 11 | | (c) As to the group health benefits program contracted to | 12 | | begin or
continue after June 30, 1973, each retired employee | 13 | | shall become immediately
eligible and covered for all benefits | 14 | | available under that program. Retired
employees may elect | 15 | | coverage for eligible dependents and shall have the
coverage | 16 | | effective immediately, provided that the election is properly
| 17 | | filed in accordance with required filing dates and procedures | 18 | | specified
by the Director.
| 19 | | Except as otherwise provided in this Act, where husband and | 20 | | wife are
both eligible members, each shall be enrolled as a | 21 | | member and coverage on
their eligible dependent children, if | 22 | | any, may be under the enrollment and
election of either.
| 23 | | Regardless of other provisions herein regarding late | 24 | | enrollment or other
qualifications, as appropriate, the
| 25 | | Director may periodically authorize open enrollment periods | 26 | | for each of the
benefit programs at which time each member may |
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| 1 | | elect enrollment or change
of enrollment without regard to age, | 2 | | sex, health, or other qualification
under the conditions as may | 3 | | be prescribed in rules and regulations
supplementing this Act. | 4 | | Special open enrollment periods may be declared by
the Director | 5 | | for certain members only when special circumstances occur that
| 6 | | affect only those members.
| 7 | | (d) Beginning with fiscal year 2003 and for all subsequent | 8 | | years, eligible
members may elect not to participate in the | 9 | | program of health benefits as
defined in this Act. The election | 10 | | must be made during the annual benefit
choice period, subject | 11 | | to the conditions in this subsection.
| 12 | | (1) Members must furnish proof of health benefit | 13 | | coverage, either
comprehensive major medical coverage or | 14 | | comprehensive managed care plan,
from a source other than | 15 | | the Department of Central Management Services in
order to | 16 | | elect not to participate in the program.
| 17 | | (2) Members may re-enroll in the Department of Central | 18 | | Management Services
program of health benefits upon | 19 | | showing a qualifying change in status, as
defined in the | 20 | | U.S. Internal Revenue Code, without evidence of | 21 | | insurability
and with no limitations on coverage for | 22 | | pre-existing conditions, provided
that there was not a | 23 | | break in coverage of more than 63 days.
| 24 | | (3) Members may also re-enroll in the program of health | 25 | | benefits during
any annual benefit choice period, without | 26 | | evidence of insurability.
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| 1 | | (4) Members who elect not to participate in the program | 2 | | of health benefits
shall be furnished a written explanation | 3 | | of the requirements and limitations
for the election not to | 4 | | participate in the program and for re-enrolling in the
| 5 | | program. The explanation shall also be included in the | 6 | | annual benefit choice
options booklets furnished to | 7 | | members.
| 8 | | (d-5) Beginning July 1, 2005, the Director may establish a | 9 | | program of financial incentives to encourage annuitants | 10 | | receiving a retirement annuity from the State Employees | 11 | | Retirement System, but who are not eligible for benefits under | 12 | | the federal Medicare health insurance program (Title XVIII of | 13 | | the Social Security Act, as added by Public Law 89-97) to elect | 14 | | not to participate in the program of health benefits provided | 15 | | under this Act. The election by an annuitant not to participate | 16 | | under this program must be made in accordance with the | 17 | | requirements set forth under subsection (d). The financial | 18 | | incentives provided to these annuitants under the program may | 19 | | not exceed $150 per month for each annuitant electing not to | 20 | | participate in the program of health benefits provided under | 21 | | this Act.
| 22 | | (d-6) Beginning July 1, 2011, the Director shall establish | 23 | | a program of financial incentives to encourage current General | 24 | | Assembly members and annuitants of the General Assembly | 25 | | Retirement System to elect not to participate in the program of | 26 | | health benefits provided under this Act. The election by a |
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| 1 | | current member or annuitant not to participate must be a | 2 | | one-time irrevocable election. The financial incentives | 3 | | provided to these current General Assembly members and | 4 | | annuitants under the program may not exceed 60% of the average | 5 | | cost of the most affordable State-offered health benefit (as | 6 | | determined by the Director) for which the member or annuitant | 7 | | qualifies. | 8 | | (e) Notwithstanding any other provision of this Act or the | 9 | | rules adopted
under this Act, if a person participating in the | 10 | | program of health benefits as
the dependent spouse of an | 11 | | eligible member becomes an annuitant, the person may
elect, at | 12 | | the time of becoming an annuitant or during any subsequent | 13 | | annual
benefit choice period, to continue participation as a | 14 | | dependent rather than
as an eligible member for as long as the | 15 | | person continues to be an eligible
dependent.
| 16 | | An eligible member who has elected to participate as a | 17 | | dependent may
re-enroll in the program of health benefits as an | 18 | | eligible member (i)
during any subsequent annual benefit choice | 19 | | period or (ii) upon showing a
qualifying change in status, as | 20 | | defined in the U.S. Internal Revenue Code,
without evidence of | 21 | | insurability and with no limitations on coverage for
| 22 | | pre-existing conditions.
| 23 | | A person who elects to participate in the program of health | 24 | | benefits as
a dependent rather than as an eligible member shall | 25 | | be furnished a written
explanation of the consequences of | 26 | | electing to participate as a dependent and
the conditions and |
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| 1 | | procedures for re-enrolling as an eligible member. The
| 2 | | explanation shall also be included in the annual benefit choice | 3 | | options booklet
furnished to members.
| 4 | | (Source: P.A. 94-95, eff. 7-1-05; 94-109, eff. 7-1-05; 95-331, | 5 | | eff. 8-21-07.)
| 6 | | Section 99. Effective date. This Act takes effect upon | 7 | | becoming law.".
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