Full Text of SB1245 98th General Assembly
SB1245sam003 98TH GENERAL ASSEMBLY | Sen. Christine Radogno Filed: 4/24/2013
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| 1 | | AMENDMENT TO SENATE BILL 1245
| 2 | | AMENDMENT NO. ______. Amend Senate Bill 1245, AS AMENDED, | 3 | | by replacing the enacting clause with the following:
| 4 | | "Section 5. The Public Safety Employee Benefits Act is | 5 | | amended by changing Section 10 and adding Section 17 as | 6 | | follows:
| 7 | | (820 ILCS 320/10)
| 8 | | Sec. 10. Required health coverage benefits.
| 9 | | (a) An employer who employs a full-time law enforcement, | 10 | | correctional or
correctional probation officer, or firefighter | 11 | | (hereinafter referred to as "injured employee") , who, on or | 12 | | after the effective
date of this Act suffers a catastrophic | 13 | | injury or is killed in the line of duty
shall pay the entire | 14 | | premium of the employer's health insurance plan for the
injured | 15 | | employee, the injured employee's spouse, and for each dependent | 16 | | child
of the injured employee until the child reaches the age |
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| 1 | | of majority or until
the end of the calendar year in which the | 2 | | child reaches the age of 25 if the
child continues to be | 3 | | dependent for support or the child is a full-time or
part-time | 4 | | student and is dependent for support. The term "health | 5 | | insurance
plan" does not include supplemental benefits that are | 6 | | not part of the basic
group health insurance plan.
If the
| 7 | | injured employee subsequently dies, the employer shall | 8 | | continue to pay the
entire health insurance premium for the | 9 | | surviving spouse until remarried and
for the dependent children | 10 | | under the conditions established in this Section.
An employer | 11 | | shall not be required to pay the premium of the health | 12 | | insurance plan as provided in this Section if the employee or | 13 | | employee's spouse: (1) is granted disability income benefits | 14 | | under Title II (42 U.S.C. 401 et seq.) or supplemental security | 15 | | income benefits under Title XVI (42 U.S.C. 1381 et seq.) of the | 16 | | Social Security Act, (2) accepts health insurance benefits from | 17 | | another source, or (3) becomes eligible for federal Medicare | 18 | | benefits. However:
| 19 | | (1) Health insurance benefits payable from any other | 20 | | source shall reduce
benefits payable under this Section.
| 21 | | (2) It is unlawful for a person to willfully and | 22 | | knowingly make, or cause
to be made, or to assist, conspire | 23 | | with, or urge another to make, or cause to
be made, any | 24 | | false, fraudulent, or misleading oral or written statement | 25 | | to
obtain health insurance coverage as provided under this | 26 | | Section. A violation
of this item is a Class A misdemeanor.
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| 1 | | (3) Upon conviction for a violation described in item | 2 | | (2), a law
enforcement, correctional or correctional | 3 | | probation officer, or other
beneficiary who receives or | 4 | | seeks to receive health insurance benefits under
this | 5 | | Section shall forfeit the right to receive health insurance | 6 | | benefits and
shall reimburse the employer for all benefits | 7 | | paid due to the fraud or other
prohibited activity. For | 8 | | purposes of this item, "conviction" means a
determination | 9 | | of guilt that is the result of a plea or trial, regardless | 10 | | of
whether adjudication is withheld.
| 11 | | (b) In order for the law enforcement, correctional or | 12 | | correctional probation
officer, firefighter, spouse, or | 13 | | dependent children to be eligible for
insurance coverage under | 14 | | this Act, the injury or death must have occurred as
the result | 15 | | of the officer's response to fresh pursuit, the officer or
| 16 | | firefighter's response to what is reasonably believed to be an | 17 | | emergency, an
unlawful act perpetrated by another, or during | 18 | | the investigation of a criminal
act. Nothing in this Section | 19 | | shall be construed to limit health insurance
coverage or | 20 | | pension benefits for which the officer, firefighter, spouse, or
| 21 | | dependent children may otherwise be eligible.
| 22 | | (c) "Catastrophic injury" means an injury that is one of | 23 | | the following: | 24 | | (1) spinal cord injury involving severe paralysis of an | 25 | | arm, a leg, or the trunk; | 26 | | (2) any amputation of an arm, a hand, a foot, or a leg |
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| 1 | | that involves the effective loss of use of that appendage; | 2 | | (3) severe brain or closed head injury as evidenced by: | 3 | | (A) severe sensory or motor disturbances; | 4 | | (B) severe communication disturbances; | 5 | | (C) severe complex integrated disturbances of | 6 | | cerebral function; | 7 | | (D) severe disturbances of consciousness; | 8 | | (E) severe episodic neurological disorders; or | 9 | | (F) other conditions at least as severe in nature | 10 | | as any condition provided in items (A) through (E); | 11 | | (4) second or third degree burns over 50% of the body | 12 | | as a whole or third degree burns to 50% or more of the face | 13 | | or hands; | 14 | | (5) total vision loss; or | 15 | | (6) any other injury, the direct and proximate cause of | 16 | | which permanently prevents an individual from performing | 17 | | any gainful work. | 18 | | (d) An injured employee who on or after the effective date | 19 | | of this amendatory Act of the 98th General Assembly suffers an | 20 | | injury that is not considered catastrophic under subsection (c) | 21 | | of this Section, but would otherwise qualify the individual to | 22 | | receive a line-of-duty disability pension that was awarded as a | 23 | | consequence of the officer's response to fresh pursuit, the | 24 | | officer's or firefighter's response to what is reasonably | 25 | | believed to be an emergency, an unlawful act perpetrated by | 26 | | another, or during the investigation of a criminal act or under |
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| 1 | | Section 3-114.1 or 4-110 of the Illinois Pension Code or a duty | 2 | | death benefit under Section 3 of the Line of Duty Compensation | 3 | | Act, shall be considered to have suffered a qualifying | 4 | | disability and shall be entitled to receive health insurance | 5 | | benefits as provided in this subsection. | 6 | | An injured employee who has suffered a qualifying | 7 | | disability is entitled to purchase or continue to purchase the | 8 | | same health insurance benefits provided by the unit of | 9 | | government at the time that the injured employee was injured | 10 | | for a period of 5 years following the qualifying disability. | 11 | | The employer shall pay not less than 50% of the total insurance | 12 | | premium. | 13 | | The injured employee is entitled to purchase or continue to | 14 | | purchase health insurance coverage until the earlier of: (1) a | 15 | | decision being rendered granting disability income benefits | 16 | | under Title II (42 U.S.C. 401 et seq.) or supplemental security | 17 | | income benefits under Title XVI (42 U.S.C. 1381 et seq.) of the | 18 | | Social Security Act, (2) the injured employee accepting health | 19 | | insurance benefits from another source, or (3) the date the | 20 | | injured employee becomes eligible for federal Medicare | 21 | | benefits. | 22 | | (e) By July 1 of every year, a person receiving benefits | 23 | | under this Act shall be required to submit to the employer, on | 24 | | a form provided by the employer, a report that shall include | 25 | | the following: | 26 | | (1) gainful employment by the beneficiary within the |
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| 1 | | reporting period; | 2 | | (2) compensation earned by the beneficiary as a result | 3 | | of the employment; | 4 | | (3) current annual household income; | 5 | | (4) whether the injured employee, or his or her spouse, | 6 | | has been offered any insurance from another source; and | 7 | | (5) whether the injured employee, or his or her spouse, | 8 | | is currently enrolled in any insurance plan from another | 9 | | source. | 10 | | Any information collected by the employer under this | 11 | | Section shall be exempt from the requirements of the Freedom of | 12 | | Information Act except data collected in the aggregate that | 13 | | does not reveal any personal information of the injured | 14 | | employee. | 15 | | (f) The employer may cancel benefits being provided under | 16 | | this Act for any beneficiary (1) whose household income exceeds | 17 | | 800% of the poverty level; (2) who has rejected an offer of | 18 | | insurance coverage from another source; or (3) who is currently | 19 | | enrolled in an insurance plan from another source. Benefits may | 20 | | be denied any individual who fails to timely file a completed | 21 | | report under this Section. Not less than 60 days prior to July | 22 | | 1, an employer shall notify any employee receiving benefits | 23 | | under this Act of that employee's obligation to file a report | 24 | | under this Section. Any employee that fails to timely file a | 25 | | report under this Section by July 1 shall be notified that he | 26 | | or she has 30 days to submit the report. Any employee who fails |
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| 1 | | to file 30 days after receiving this notice may be denied | 2 | | benefits. | 3 | | (Source: P.A. 90-535, eff. 11-14-97.)
| 4 | | (820 ILCS 320/17 new) | 5 | | Sec. 17. Claims report. | 6 | | (a) An employer subject to this Act shall file a claims | 7 | | report with the Public Pension Division of the Department of | 8 | | Insurance in the format prepared by the Division. The Division | 9 | | shall design the form and prescribe the content of the report. | 10 | | At least 60 days before the filing deadline, the Division shall | 11 | | provide the form to the employers subject to this Act. The | 12 | | claims report shall be filed no later than December 31 of each | 13 | | year. The claims report shall set forth the required | 14 | | information for the 12-month period ending on June 30 preceding | 15 | | the deadline date for filing the report. The claims report | 16 | | shall, at a minimum, contain the following information: | 17 | | (1) the number of claims filed under this Act during | 18 | | the reporting period; | 19 | | (2) the number of claims awarded under this Act during | 20 | | the reporting period; | 21 | | (3) the dollar amount of all claims awarded under this | 22 | | Act during the reporting period; | 23 | | (4) the number of claims paid under this Act during the | 24 | | reporting period regardless of when the claim was awarded; | 25 | | (5) the dollar amount of all claims paid under this Act |
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| 1 | | during the reporting period regardless of when the claim | 2 | | was awarded; | 3 | | (6) the annual cost of the benefit and any available | 4 | | long-term cost projections; | 5 | | (7) the nature of the injury; | 6 | | (8) any gainful employment during the annual reporting | 7 | | period; | 8 | | (9) the compensation earned as a result of that | 9 | | employment; and | 10 | | (10) any accessible insurance options. | 11 | | The claims report shall redact any information as required by | 12 | | the Health Insurance Portability and Accountability Act of 1996 | 13 | | (HIPAA). | 14 | | (b) On or before July 1 of each year, the Public Pension | 15 | | Division of the Department of Insurance shall submit a report | 16 | | to the Governor and General Assembly setting forth the | 17 | | information received under subsection (a) with respect to the | 18 | | most recently completed reporting period. The requirement for | 19 | | reporting to the General Assembly shall be satisfied by filing | 20 | | copies of the report with the Speaker, Minority Leader, and | 21 | | Clerk of the House of Representatives, the President, Minority | 22 | | Leader, and Secretary of the Senate, the Legislative Research | 23 | | Unit as required under Section 3.1 of the General Assembly | 24 | | Organization Act, and the State Government Report Distribution | 25 | | Center for the General Assembly as required under paragraph (t) | 26 | | of Section 7 of the State Library Act. Upon request, the |
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| 1 | | Division shall provide copies of the report at no charge to | 2 | | employers subject to this Act, to public libraries, and to | 3 | | State agencies. | 4 | | (c) By July 1 of every year, a person receiving benefits | 5 | | under this Act shall be required to file, on a form provided by | 6 | | the employer, a report that shall include the following: | 7 | | (1) gainful employment by the beneficiary within the | 8 | | reporting period; | 9 | | (2) compensation earned by the beneficiary as a result | 10 | | of the employment; | 11 | | (3) current annual household income; | 12 | | (4) whether the injured employee, or his or her spouse, | 13 | | has been offered comparable insurance from another source; | 14 | | and | 15 | | (5) whether the injured employee, or his or her spouse, | 16 | | is currently enrolled in a comparable insurance plan from | 17 | | another source. | 18 | | Benefits may be denied any individual who fails to timely | 19 | | file a report under this subsection.
| 20 | | Section 99. Effective date. This Act takes effect upon | 21 | | becoming law.".
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