Full Text of SB0175 97th General Assembly
SB0175sam001 97TH GENERAL ASSEMBLY | Sen. Jeffrey M. Schoenberg Filed: 5/25/2011
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| 1 | | AMENDMENT TO SENATE BILL 175
| 2 | | AMENDMENT NO. ______. Amend Senate Bill 175 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 10 as follows:
| 6 | | (5 ILCS 375/10) (from Ch. 127, par. 530)
| 7 | | Sec. 10. Payments by State; premiums.
| 8 | | (a) The State shall pay the cost of basic non-contributory | 9 | | group life
insurance and, subject to member paid contributions | 10 | | set by the Department or
required by this Section, the basic | 11 | | program of group health benefits on each
eligible member, | 12 | | except a member, not otherwise
covered by this Act, who has | 13 | | retired as a participating member under Article 2
of the | 14 | | Illinois Pension Code but is ineligible for the retirement | 15 | | annuity under
Section 2-119 of the Illinois Pension Code, and | 16 | | part of each eligible member's
and retired member's premiums |
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| 1 | | for health insurance coverage for enrolled
dependents as | 2 | | provided by Section 9. The State shall pay the cost of the | 3 | | basic
program of group health benefits only after benefits are | 4 | | reduced by the amount
of benefits covered by Medicare for all | 5 | | members and dependents
who are eligible for benefits under | 6 | | Social Security or
the Railroad Retirement system or who had | 7 | | sufficient Medicare-covered
government employment, except that | 8 | | such reduction in benefits shall apply only
to those members | 9 | | and dependents who (1) first become eligible
for such Medicare | 10 | | coverage on or after July 1, 1992; or (2) are
Medicare-eligible | 11 | | members or dependents of a local government unit which began
| 12 | | participation in the program on or after July 1, 1992; or (3) | 13 | | remain eligible
for, but no longer receive Medicare coverage | 14 | | which they had been receiving on
or after July 1, 1992. The | 15 | | Department may determine the aggregate level of the
State's | 16 | | contribution on the basis of actual cost of medical services | 17 | | adjusted
for age, sex or geographic or other demographic | 18 | | characteristics which affect
the costs of such programs.
| 19 | | The cost of participation in the basic program of group | 20 | | health benefits
for the dependent or survivor of a living or | 21 | | deceased retired employee who was
formerly employed by the | 22 | | University of Illinois in the Cooperative Extension
Service and | 23 | | would be an annuitant but for the fact that he or she was made
| 24 | | ineligible to participate in the State Universities Retirement | 25 | | System by clause
(4) of subsection (a) of Section 15-107 of the | 26 | | Illinois Pension Code shall not
be greater than the cost of |
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| 1 | | participation that would otherwise apply to that
dependent or | 2 | | survivor if he or she were the dependent or survivor of an
| 3 | | annuitant under the State Universities Retirement System.
| 4 | | (a-1) Beginning January 1, 1998, for each person who | 5 | | becomes a new SERS
annuitant and participates in the basic | 6 | | program of group health benefits, the
State shall contribute | 7 | | toward the cost of the annuitant's
coverage under the basic | 8 | | program of group health benefits an amount equal
to 5% of that | 9 | | cost for each full year of creditable service upon which the
| 10 | | annuitant's retirement annuity is based, up to a maximum of | 11 | | 100% for an
annuitant with 20 or more years of creditable | 12 | | service.
The remainder of the cost of a new SERS annuitant's | 13 | | coverage under the basic
program of group health benefits shall | 14 | | be the responsibility of the
annuitant. In the case of a new | 15 | | SERS annuitant who has elected to receive an alternative | 16 | | retirement cancellation payment under Section 14-108.5 of the | 17 | | Illinois Pension Code in lieu of an annuity, for the purposes | 18 | | of this subsection the annuitant shall be deemed to be | 19 | | receiving a retirement annuity based on the number of years of | 20 | | creditable service that the annuitant had established at the | 21 | | time of his or her termination of service under SERS.
| 22 | | (a-2) Beginning January 1, 1998, for each person who | 23 | | becomes a new SERS
survivor and participates in the basic | 24 | | program of group health benefits, the
State shall contribute | 25 | | toward the cost of the survivor's
coverage under the basic | 26 | | program of group health benefits an amount equal
to 5% of that |
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| 1 | | cost for each full year of the deceased employee's or deceased
| 2 | | annuitant's creditable service in the State Employees' | 3 | | Retirement System of
Illinois on the date of death, up to a | 4 | | maximum of 100% for a survivor of an
employee or annuitant with | 5 | | 20 or more years of creditable service. The
remainder of the | 6 | | cost of the new SERS survivor's coverage under the basic
| 7 | | program of group health benefits shall be the responsibility of | 8 | | the survivor. In the case of a new SERS survivor who was the | 9 | | dependent of an annuitant who elected to receive an alternative | 10 | | retirement cancellation payment under Section 14-108.5 of the | 11 | | Illinois Pension Code in lieu of an annuity, for the purposes | 12 | | of this subsection the deceased annuitant's creditable service | 13 | | shall be determined as of the date of termination of service | 14 | | rather than the date of death.
| 15 | | (a-3) Beginning January 1, 1998, for each person who | 16 | | becomes a new SURS
annuitant and participates in the basic | 17 | | program of group health benefits, the
State shall contribute | 18 | | toward the cost of the annuitant's
coverage under the basic | 19 | | program of group health benefits an amount equal
to 5% of that | 20 | | cost for each full year of creditable service upon which the
| 21 | | annuitant's retirement annuity is based, up to a maximum of | 22 | | 100% for an
annuitant with 20 or more years of creditable | 23 | | service.
The remainder of the cost of a new SURS annuitant's | 24 | | coverage under the basic
program of group health benefits shall | 25 | | be the responsibility of the
annuitant.
| 26 | | (a-4) (Blank).
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| 1 | | (a-5) Beginning January 1, 1998, for each person who | 2 | | becomes a new SURS
survivor and participates in the basic | 3 | | program of group health benefits, the
State shall contribute | 4 | | toward the cost of the survivor's coverage under the
basic | 5 | | program of group health benefits an amount equal to 5% of that | 6 | | cost for
each full year of the deceased employee's or deceased | 7 | | annuitant's creditable
service in the State Universities | 8 | | Retirement System on the date of death, up to
a maximum of 100% | 9 | | for a survivor of an
employee or annuitant with 20 or more | 10 | | years of creditable service. The
remainder of the cost of the | 11 | | new SURS survivor's coverage under the basic
program of group | 12 | | health benefits shall be the responsibility of the survivor.
| 13 | | (a-6) Beginning July 1, 1998, for each person who becomes a | 14 | | new TRS
State annuitant and participates in the basic program | 15 | | of group health benefits,
the State shall contribute toward the | 16 | | cost of the annuitant's coverage under
the basic program of | 17 | | group health benefits an amount equal to 5% of that cost
for | 18 | | each full year of creditable service
as a teacher as defined in | 19 | | paragraph (2), (3), or (5) of Section 16-106 of the
Illinois | 20 | | Pension Code
upon which the annuitant's retirement annuity is | 21 | | based, up to a maximum of
100%;
except that
the State | 22 | | contribution shall be 12.5% per year (rather than 5%) for each | 23 | | full
year of creditable service as a regional superintendent or | 24 | | assistant regional
superintendent of schools. The
remainder of | 25 | | the cost of a new TRS State annuitant's coverage under the | 26 | | basic
program of group health benefits shall be the |
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| 1 | | responsibility of the
annuitant.
| 2 | | (a-7) Beginning July 1, 1998, for each person who becomes a | 3 | | new TRS
State survivor and participates in the basic program of | 4 | | group health benefits,
the State shall contribute toward the | 5 | | cost of the survivor's coverage under the
basic program of | 6 | | group health benefits an amount equal to 5% of that cost for
| 7 | | each full year of the deceased employee's or deceased | 8 | | annuitant's creditable
service
as a teacher as defined in | 9 | | paragraph (2), (3), or (5) of Section 16-106 of the
Illinois | 10 | | Pension Code
on the date of death, up to a maximum of 100%;
| 11 | | except that the State contribution shall be 12.5% per year | 12 | | (rather than 5%) for
each full year of the deceased employee's | 13 | | or deceased annuitant's creditable
service as a regional | 14 | | superintendent or assistant regional superintendent of
| 15 | | schools.
The remainder of
the cost of the new TRS State | 16 | | survivor's coverage under the basic program of
group health | 17 | | benefits shall be the responsibility of the survivor.
| 18 | | (a-8) A new SERS annuitant, new SERS survivor, new SURS
| 19 | | annuitant, new SURS survivor, new TRS State
annuitant, or new | 20 | | TRS State survivor may waive or terminate coverage in
the | 21 | | program of group health benefits. Any such annuitant or | 22 | | survivor
who has waived or terminated coverage may enroll or | 23 | | re-enroll in the
program of group health benefits only during | 24 | | the annual benefit choice period,
as determined by the | 25 | | Director; except that in the event of termination of
coverage | 26 | | due to nonpayment of premiums, the annuitant or survivor
may |
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| 1 | | not re-enroll in the program.
| 2 | | (a-9) No later than May 1 of each calendar year, the | 3 | | Director
of Central Management Services shall certify in | 4 | | writing to the Executive
Secretary of the State Employees' | 5 | | Retirement System of Illinois the amounts
of the Medicare | 6 | | supplement health care premiums and the amounts of the
health | 7 | | care premiums for all other retirees who are not Medicare | 8 | | eligible.
| 9 | | A separate calculation of the premiums based upon the | 10 | | actual cost of each
health care plan shall be so certified.
| 11 | | The Director of Central Management Services shall provide | 12 | | to the
Executive Secretary of the State Employees' Retirement | 13 | | System of
Illinois such information, statistics, and other data | 14 | | as he or she
may require to review the premium amounts | 15 | | certified by the Director
of Central Management Services.
| 16 | | The Department of Healthcare and Family Services, or any | 17 | | successor agency designated to procure healthcare contracts | 18 | | pursuant to this Act, is authorized to establish funds, | 19 | | separate accounts provided by any bank or banks as defined by | 20 | | the Illinois Banking Act, or separate accounts provided by any | 21 | | savings and loan association or associations as defined by the | 22 | | Illinois Savings and Loan Act of 1985 to be held by the | 23 | | Director, outside the State treasury, for the purpose of | 24 | | receiving the transfer of moneys from the Local Government | 25 | | Health Insurance Reserve Fund. The Department may promulgate | 26 | | rules further defining the methodology for the transfers. Any |
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| 1 | | interest earned by moneys in the funds or accounts shall inure | 2 | | to the Local Government Health Insurance Reserve Fund. The | 3 | | transferred moneys, and interest accrued thereon, shall be used | 4 | | exclusively for transfers to administrative service | 5 | | organizations or their financial institutions for payments of | 6 | | claims to claimants and providers under the self-insurance | 7 | | health plan. The transferred moneys, and interest accrued | 8 | | thereon, shall not be used for any other purpose including, but | 9 | | not limited to, reimbursement of administration fees due the | 10 | | administrative service organization pursuant to its contract | 11 | | or contracts with the Department.
| 12 | | (a-10) Notwithstanding any provision of this Act to the | 13 | | contrary, beginning January 1, 2012, annuitants and survivors | 14 | | must pay premiums in order to obtain coverage for themselves | 15 | | and any dependents under the program of group health benefits | 16 | | provided under this Act. The Director shall determine the | 17 | | amount of the premium to be paid by each annuitant and | 18 | | survivor, based upon a system that takes into account (i) | 19 | | points, which are calculated by summing the retiree's age when | 20 | | benefits commenced and his or her total years of service, and | 21 | | (ii) annual household annual income, according to the following | 22 | | schedule: | 23 | | (1) For retirees with 78 or fewer points and: | 24 | | (A) An estimated household income of less than | 25 | | $30,000, 0% of the applicable premium. | 26 | | (B) An estimated household income of at least |
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| 1 | | $30,000 but less than $60,000, 55% of the applicable | 2 | | premium. | 3 | | (C) An estimated household income of at least | 4 | | $60,000 but less than $100,000, 65% of the applicable | 5 | | premium. | 6 | | (D) An estimated household income of at least | 7 | | $100,000 but less than $200,000, 75% of the applicable | 8 | | premium. | 9 | | (E) An estimated household income of at least | 10 | | $200,000 but less than $250,000, 100% of the applicable | 11 | | premium. | 12 | | (F) An estimated household income of $250,000 or | 13 | | more, 100% of the applicable premium. | 14 | | (2) For retirees with 79 to 85 points and: | 15 | | (A) An estimated household income of less than | 16 | | $30,000, 0% of the applicable premium. | 17 | | (B) An estimated household income of at least | 18 | | $30,000 but less than $60,000, 50% of the applicable | 19 | | premium. | 20 | | (C) An estimated household income of at least | 21 | | $60,000 but less than $100,000, 60% of the applicable | 22 | | premium. | 23 | | (D) An estimated household income of at least | 24 | | $100,000 but less than $200,000, 70% of the applicable | 25 | | premium. | 26 | | (E) An estimated household income of at least |
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| 1 | | $200,000 but less than $250,000, 100% of the applicable | 2 | | premium. | 3 | | (F) An estimated household income of $250,000 or | 4 | | more, 100% of the applicable premium. | 5 | | (3) For retirees with 86 to 92 points and: | 6 | | (A) An estimated household income of less than | 7 | | $30,000, 0% of the applicable premium. | 8 | | (B) An estimated household income of at least | 9 | | $30,000 but less than $60,000, 45% of the applicable | 10 | | premium. | 11 | | (C) An estimated household income of at least | 12 | | $60,000 but less than $100,000, 55% of the applicable | 13 | | premium. | 14 | | (D) An estimated household income of at least | 15 | | $100,000 but less than $200,000, 65% of the applicable | 16 | | premium. | 17 | | (E) An estimated household income of at least | 18 | | $200,000 but less than $250,000, 100% of the applicable | 19 | | premium. | 20 | | (F) An estimated household income of $250,000 or | 21 | | more, 100% of the applicable premium. | 22 | | (4) For retirees with 93 or more points and: | 23 | | (A) An estimated household income of less than | 24 | | $30,000, 0% of the applicable premium. | 25 | | (B) An estimated household income of at least | 26 | | $30,000 but less than $60,000, 35% of the applicable |
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| 1 | | premium. | 2 | | (C) An estimated household income of at least | 3 | | $60,000 but less than $100,000, 45% of the applicable | 4 | | premium. | 5 | | (D) An estimated household income of at least | 6 | | $100,000 but less than $200,000, 55% of the applicable | 7 | | premium. | 8 | | (E) An estimated household income of at least | 9 | | $200,000 but less than $250,000, 100% of the applicable | 10 | | premium. | 11 | | (F) An estimated household income of $250,000 or | 12 | | more, 100% of the applicable premium. | 13 | | The Director shall establish a process for determining a | 14 | | retiree's household income by administrative rule. This | 15 | | income-verification process must use a retiree's pension | 16 | | income as the basis for determining his or her household | 17 | | income. The Director shall also establish by rule a process for | 18 | | retirees to appeal determinations of household income. | 19 | | The obligation of each annuitant and survivor to pay the | 20 | | required premium applies only to the extent that the obligation | 21 | | is consistent with any contractual obligations existing in any | 22 | | collective bargaining agreement in effect on the effective date | 23 | | of this amendatory Act of the 97th General Assembly. | 24 | | Beginning July 1, 2012, the Director may alter the schedule | 25 | | above to ensure that 49% of the costs associated with the basic | 26 | | program of group health benefits are covered by participating |
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| 1 | | annuitants, survivors, and dependents. | 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. This coverage shall continue until
expiration | 18 | | of authorized leave and return to active service, but not to | 19 | | exceed
24 months for leaves under item (1) or (2). This | 20 | | 24-month limitation and the
requirement of returning to active | 21 | | service shall not apply to persons receiving
ordinary or | 22 | | accidental disability benefits or retirement benefits through | 23 | | the
appropriate State retirement system or benefits under the | 24 | | Workers' Compensation
or Occupational Disease Act.
| 25 | | (d) The basic group life insurance coverage shall continue, | 26 | | with
full State contribution, where such person is (1) absent |
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| 1 | | from active
service by reason of disability arising from any | 2 | | cause other than
self-inflicted, (2) on authorized educational | 3 | | leave of absence or
sabbatical leave, or (3) on military leave.
| 4 | | (e) Where the person is in non-pay status for a period in | 5 | | excess of
30 days or on leave of absence, other than by reason | 6 | | of disability,
educational or sabbatical leave, or military | 7 | | leave, such
person may continue coverage only by making | 8 | | personal
payment equal to the amount normally contributed by | 9 | | the State on such person's
behalf. Such payments and coverage | 10 | | may be continued: (1) until such time as
the person returns to | 11 | | a status eligible for coverage at State expense, but not
to | 12 | | exceed 24 months or (2) until such person's employment or | 13 | | annuitant status
with the State is terminated (exclusive of any | 14 | | additional service imposed pursuant to law).
| 15 | | (f) The Department shall establish by rule the extent to | 16 | | which other
employee benefits will continue for persons in | 17 | | non-pay status or who are
not in active service.
| 18 | | (g) The State shall not pay the cost of the basic | 19 | | non-contributory
group life insurance, program of health | 20 | | benefits and other employee benefits
for members who are | 21 | | survivors as defined by paragraphs (1) and (2) of
subsection | 22 | | (q) of Section 3 of this Act. The costs of benefits for these
| 23 | | survivors shall be paid by the survivors or by the University | 24 | | of Illinois
Cooperative Extension Service, or any combination | 25 | | thereof.
However, the State shall pay the amount of the | 26 | | reduction in the cost of
participation, if any, resulting from |
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| 1 | | the amendment to subsection (a) made
by this amendatory Act of | 2 | | the 91st General Assembly.
| 3 | | (h) Those persons occupying positions with any department | 4 | | as a result
of emergency appointments pursuant to Section 8b.8 | 5 | | of the Personnel Code
who are not considered employees under | 6 | | this Act shall be given the option
of participating in the | 7 | | programs of group life insurance, health benefits and
other | 8 | | employee benefits. Such persons electing coverage may | 9 | | participate only
by making payment equal to the amount normally | 10 | | contributed by the State for
similarly situated employees. Such | 11 | | amounts shall be determined by the
Director. Such payments and | 12 | | coverage may be continued until such time as the
person becomes | 13 | | an employee pursuant to this Act or such person's appointment | 14 | | is
terminated.
| 15 | | (i) Any unit of local government within the State of | 16 | | Illinois
may apply to the Director to have its employees, | 17 | | annuitants, and their
dependents provided group health | 18 | | coverage under this Act on a non-insured
basis. To participate, | 19 | | a unit of local government must agree to enroll
all of its | 20 | | employees, who may select coverage under either the State group
| 21 | | health benefits plan or a health maintenance organization that | 22 | | has
contracted with the State to be available as a health care | 23 | | provider for
employees as defined in this Act. A unit of local | 24 | | government must remit the
entire cost of providing coverage | 25 | | under the State group health benefits plan
or, for coverage | 26 | | under a health maintenance organization, an amount determined
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| 1 | | by the Director based on an analysis of the sex, age, | 2 | | geographic location, or
other relevant demographic variables | 3 | | for its employees, except that the unit of
local government | 4 | | shall not be required to enroll those of its employees who are
| 5 | | covered spouses or dependents under this plan or another group | 6 | | policy or plan
providing health benefits as long as (1) an | 7 | | appropriate official from the unit
of local government attests | 8 | | that each employee not enrolled is a covered spouse
or | 9 | | dependent under this plan or another group policy or plan, and | 10 | | (2) at least
50% of the employees are enrolled and the unit of | 11 | | local government remits
the entire cost of providing coverage | 12 | | to those employees, except that a
participating school district | 13 | | must have enrolled at least 50% of its full-time
employees who | 14 | | have not waived coverage under the district's group health
plan | 15 | | by participating in a component of the district's cafeteria | 16 | | plan. A
participating school district is not required to enroll | 17 | | a full-time employee
who has waived coverage under the | 18 | | district's health plan, provided that an
appropriate official | 19 | | from the participating school district attests that the
| 20 | | full-time employee has waived coverage by participating in a | 21 | | component of the
district's cafeteria plan. For the purposes of | 22 | | this subsection, "participating
school district" includes a | 23 | | unit of local government whose primary purpose is
education as | 24 | | defined by the Department's rules.
| 25 | | Employees of a participating unit of local government who | 26 | | are not enrolled
due to coverage under another group health |
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| 1 | | policy or plan may enroll in
the event of a qualifying change | 2 | | in status, special enrollment, special
circumstance as defined | 3 | | by the Director, or during the annual Benefit Choice
Period. A | 4 | | participating unit of local government may also elect to cover | 5 | | its
annuitants. Dependent coverage shall be offered on an | 6 | | optional basis, with the
costs paid by the unit of local | 7 | | government, its employees, or some combination
of the two as | 8 | | determined by the unit of local government. The unit of local
| 9 | | government shall be responsible for timely collection and | 10 | | transmission of
dependent premiums.
| 11 | | The Director shall annually determine monthly rates of | 12 | | payment, subject
to the following constraints:
| 13 | | (1) In the first year of coverage, the rates shall be | 14 | | equal to the
amount normally charged to State employees for | 15 | | elected optional coverages
or for enrolled dependents | 16 | | coverages or other contributory coverages, or
contributed | 17 | | by the State for basic insurance coverages on behalf of its
| 18 | | employees, adjusted for differences between State | 19 | | employees and employees
of the local government in age, | 20 | | sex, geographic location or other relevant
demographic | 21 | | variables, plus an amount sufficient to pay for the | 22 | | additional
administrative costs of providing coverage to | 23 | | employees of the unit of
local government and their | 24 | | dependents.
| 25 | | (2) In subsequent years, a further adjustment shall be | 26 | | made to reflect
the actual prior years' claims experience |
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| 1 | | of the employees of the unit of
local government.
| 2 | | In the case of coverage of local government employees under | 3 | | a health
maintenance organization, the Director shall annually | 4 | | determine for each
participating unit of local government the | 5 | | maximum monthly amount the unit
may contribute toward that | 6 | | coverage, based on an analysis of (i) the age,
sex, geographic | 7 | | location, and other relevant demographic variables of the
| 8 | | unit's employees and (ii) the cost to cover those employees | 9 | | under the State
group health benefits plan. The Director may | 10 | | similarly determine the
maximum monthly amount each unit of | 11 | | local government may contribute toward
coverage of its | 12 | | employees' dependents under a health maintenance organization.
| 13 | | Monthly payments by the unit of local government or its | 14 | | employees for
group health benefits plan or health maintenance | 15 | | organization coverage shall
be deposited in the Local | 16 | | Government Health Insurance Reserve Fund.
| 17 | | The Local Government Health Insurance Reserve Fund is | 18 | | hereby created as a nonappropriated trust fund to be held | 19 | | outside the State Treasury, with the State Treasurer as | 20 | | custodian. The Local Government Health Insurance Reserve Fund | 21 | | shall be a continuing
fund not subject to fiscal year | 22 | | limitations. The Local Government Health Insurance Reserve | 23 | | Fund is not subject to administrative charges or charge-backs, | 24 | | including but not limited to those authorized under Section 8h | 25 | | of the State Finance Act. All revenues arising from the | 26 | | administration of the health benefits program established |
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| 1 | | under this Section shall be deposited into the Local Government | 2 | | Health Insurance Reserve Fund. Any interest earned on moneys in | 3 | | the Local Government Health Insurance Reserve Fund shall be | 4 | | deposited into the Fund. All expenditures from this Fund
shall | 5 | | be used for payments for health care benefits for local | 6 | | government and rehabilitation facility
employees, annuitants, | 7 | | and dependents, and to reimburse the Department or
its | 8 | | administrative service organization for all expenses incurred | 9 | | in the
administration of benefits. No other State funds may be | 10 | | used for these
purposes.
| 11 | | A local government employer's participation or desire to | 12 | | participate
in a program created under this subsection shall | 13 | | not limit that employer's
duty to bargain with the | 14 | | representative of any collective bargaining unit
of its | 15 | | employees.
| 16 | | (j) Any rehabilitation facility within the State of | 17 | | Illinois may apply
to the Director to have its employees, | 18 | | annuitants, and their eligible
dependents provided group | 19 | | health coverage under this Act on a non-insured
basis. To | 20 | | participate, a rehabilitation facility must agree to enroll all
| 21 | | of its employees and remit the entire cost of providing such | 22 | | coverage for
its employees, except that the rehabilitation | 23 | | facility shall not be
required to enroll those of its employees | 24 | | who are covered spouses or
dependents under this plan or | 25 | | another group policy or plan providing health
benefits as long | 26 | | as (1) an appropriate official from the rehabilitation
facility |
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| 1 | | attests that each employee not enrolled is a covered spouse or
| 2 | | dependent under this plan or another group policy or plan, and | 3 | | (2) at least
50% of the employees are enrolled and the | 4 | | rehabilitation facility remits
the entire cost of providing | 5 | | coverage to those employees. Employees of a
participating | 6 | | rehabilitation facility who are not enrolled due to coverage
| 7 | | under another group health policy or plan may enroll
in the | 8 | | event of a qualifying change in status, special enrollment, | 9 | | special
circumstance as defined by the Director, or during the | 10 | | annual Benefit Choice
Period. A participating rehabilitation | 11 | | facility may also elect
to cover its annuitants. Dependent | 12 | | coverage shall be offered on an optional
basis, with the costs | 13 | | paid by the rehabilitation facility, its employees, or
some | 14 | | combination of the 2 as determined by the rehabilitation | 15 | | facility. The
rehabilitation facility shall be responsible for | 16 | | timely collection and
transmission of dependent premiums.
| 17 | | The Director shall annually determine quarterly rates of | 18 | | payment, subject
to the following constraints:
| 19 | | (1) In the first year of coverage, the rates shall be | 20 | | equal to the amount
normally charged to State employees for | 21 | | elected optional coverages or for
enrolled dependents | 22 | | coverages or other contributory coverages on behalf of
its | 23 | | employees, adjusted for differences between State | 24 | | employees and
employees of the rehabilitation facility in | 25 | | age, sex, geographic location
or other relevant | 26 | | demographic variables, plus an amount sufficient to pay
for |
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| 1 | | the additional administrative costs of providing coverage | 2 | | to employees
of the rehabilitation facility 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
rehabilitation facility.
| 7 | | Monthly payments by the rehabilitation facility or its | 8 | | employees for
group health benefits shall be deposited in the | 9 | | Local Government Health
Insurance Reserve Fund.
| 10 | | (k) Any domestic violence shelter or service within the | 11 | | State of Illinois
may apply to the Director to have its | 12 | | employees, annuitants, and their
dependents provided group | 13 | | health coverage under this Act on a non-insured
basis. To | 14 | | participate, a domestic violence shelter or service must agree | 15 | | to
enroll all of its employees and pay the entire cost of | 16 | | providing such coverage
for its employees. The domestic | 17 | | violence shelter shall not be required to enroll those of its | 18 | | employees who are covered spouses or dependents under this plan | 19 | | or another group policy or plan providing health benefits as | 20 | | long as (1) an appropriate official from the domestic violence | 21 | | shelter attests that each employee not enrolled is a covered | 22 | | spouse or dependent under this plan or another group policy or | 23 | | plan and (2) at least 50% of the employees are enrolled and the | 24 | | domestic violence shelter remits the entire cost of providing | 25 | | coverage to those employees. Employees of a participating | 26 | | domestic violence shelter who are not enrolled due to coverage |
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| 1 | | under another group health policy or plan may enroll in the | 2 | | event of a qualifying change in status, special enrollment, or | 3 | | special circumstance as defined by the Director or during the | 4 | | annual Benefit Choice Period. A participating domestic | 5 | | violence shelter may also elect
to cover its annuitants. | 6 | | Dependent coverage shall be offered on an optional
basis, with
| 7 | | employees, or some combination of the 2 as determined by the | 8 | | domestic violence
shelter or service. The domestic violence | 9 | | shelter or service shall be
responsible for timely collection | 10 | | and transmission of dependent premiums.
| 11 | | The Director shall annually determine rates of payment,
| 12 | | subject to the following constraints:
| 13 | | (1) In the first year of coverage, the rates shall be | 14 | | equal to the
amount normally charged to State employees for | 15 | | elected optional coverages
or for enrolled dependents | 16 | | coverages or other contributory coverages on
behalf of its | 17 | | employees, adjusted for differences between State | 18 | | employees and
employees of the domestic violence shelter or | 19 | | service in age, sex, geographic
location or other relevant | 20 | | demographic variables, plus an amount sufficient
to pay for | 21 | | the additional administrative costs of providing coverage | 22 | | to
employees of the domestic violence shelter or service | 23 | | and their dependents.
| 24 | | (2) In subsequent years, a further adjustment shall be | 25 | | made to reflect
the actual prior years' claims experience | 26 | | of the employees of the domestic
violence shelter or |
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| 1 | | service.
| 2 | | Monthly payments by the domestic violence shelter or | 3 | | service or its employees
for group health insurance shall be | 4 | | deposited in the Local Government Health
Insurance Reserve | 5 | | Fund.
| 6 | | (l) A public community college or entity organized pursuant | 7 | | to the
Public Community College Act may apply to the Director | 8 | | initially to have
only annuitants not covered prior to July 1, | 9 | | 1992 by the district's health
plan provided health coverage | 10 | | under this Act on a non-insured basis. The
community college | 11 | | must execute a 2-year contract to participate in the
Local | 12 | | Government Health Plan.
Any annuitant may enroll in the event | 13 | | of a qualifying change in status, special
enrollment, special | 14 | | circumstance as defined by the Director, or during the
annual | 15 | | Benefit Choice Period.
| 16 | | The Director shall annually determine monthly rates of | 17 | | payment subject to
the following constraints: for those | 18 | | community colleges with annuitants
only enrolled, first year | 19 | | rates shall be equal to the average cost to cover
claims for a | 20 | | State member adjusted for demographics, Medicare
| 21 | | participation, and other factors; and in the second year, a | 22 | | further adjustment
of rates shall be made to reflect the actual | 23 | | first year's claims experience
of the covered annuitants.
| 24 | | (l-5) The provisions of subsection (l) become inoperative | 25 | | on July 1, 1999.
| 26 | | (m) The Director shall adopt any rules deemed necessary for
|
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| 1 | | implementation of this amendatory Act of 1989 (Public Act | 2 | | 86-978).
| 3 | | (n) Any child advocacy center within the State of Illinois | 4 | | may apply to the Director to have its employees, annuitants, | 5 | | and their dependents provided group health coverage under this | 6 | | Act on a non-insured basis. To participate, a child advocacy | 7 | | center must agree to enroll all of its employees and pay the | 8 | | entire cost of providing coverage for its employees. The child
| 9 | | advocacy center shall not be required to enroll those of its
| 10 | | employees who are covered spouses or dependents under this plan
| 11 | | or another group policy or plan providing health benefits as
| 12 | | long as (1) an appropriate official from the child advocacy
| 13 | | center attests that each employee not enrolled is a covered
| 14 | | spouse or dependent under this plan or another group policy or
| 15 | | plan and (2) at least 50% of the employees are enrolled and the | 16 | | child advocacy center remits the entire cost of providing | 17 | | coverage to those employees. Employees of a participating child | 18 | | advocacy center who are not enrolled due to coverage under | 19 | | another group health policy or plan may enroll in the event of | 20 | | a qualifying change in status, special enrollment, or special | 21 | | circumstance as defined by the Director or during the annual | 22 | | Benefit Choice Period. A participating child advocacy center | 23 | | may also elect to cover its annuitants. Dependent coverage | 24 | | shall be offered on an optional basis, with the costs paid by | 25 | | the child advocacy center, its employees, or some combination | 26 | | of the 2 as determined by the child advocacy center. The child |
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| 1 | | advocacy center shall be responsible for timely collection and | 2 | | transmission of dependent premiums. | 3 | | The Director shall annually determine rates of payment, | 4 | | subject to the following constraints: | 5 | | (1) In the first year of coverage, the rates shall be | 6 | | equal to the amount normally charged to State employees for | 7 | | elected optional coverages or for enrolled dependents | 8 | | coverages or other contributory coverages on behalf of its | 9 | | employees, adjusted for differences between State | 10 | | employees and employees of the child advocacy center in | 11 | | age, sex, geographic location, or other relevant | 12 | | demographic variables, plus an amount sufficient to pay for | 13 | | the additional administrative costs of providing coverage | 14 | | to employees of the child advocacy center and their | 15 | | dependents. | 16 | | (2) In subsequent years, a further adjustment shall be | 17 | | made to reflect the actual prior years' claims experience | 18 | | of the employees of the child advocacy center. | 19 | | Monthly payments by the child advocacy center or its | 20 | | employees for group health insurance shall be deposited into | 21 | | the Local Government Health Insurance Reserve Fund. | 22 | | (Source: P.A. 95-331, eff. 8-21-07; 95-632, eff. 9-25-07; | 23 | | 95-707, eff. 1-11-08; 96-756, eff. 1-1-10; 96-1232, eff. | 24 | | 7-23-10; 96-1519, eff. 2-4-11.)
| 25 | | Section 99. Effective date. This Act takes effect January |
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| 1 | | 1, 2012.".
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