Full Text of HB0139 101st General Assembly
HB0139ham001 101ST GENERAL ASSEMBLY | Rep. LaToya Greenwood Filed: 4/9/2019
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| 1 | | AMENDMENT TO HOUSE BILL 139
| 2 | | AMENDMENT NO. ______. Amend House Bill 139 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. Contributions by the State and members.
| 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 and except as | 11 | | provided in this Section, the basic program of group health | 12 | | benefits on each
eligible member, except a member, not | 13 | | otherwise
covered by this Act, who has retired as a | 14 | | participating member under Article 2
of the Illinois Pension | 15 | | Code but is ineligible for the retirement annuity under
Section | 16 | | 2-119 of the Illinois Pension Code, and part of each eligible |
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| 1 | | member's
and retired member's premiums for health insurance | 2 | | coverage for enrolled
dependents as provided by Section 9. The | 3 | | State shall pay the cost of the basic
program of group health | 4 | | benefits only after benefits are reduced by the amount
of | 5 | | benefits covered by Medicare for all members and dependents
who | 6 | | are eligible for benefits under Social Security or
the Railroad | 7 | | Retirement system or who had sufficient Medicare-covered
| 8 | | government employment, except that such reduction in benefits | 9 | | shall apply only
to those members and dependents who (1) first | 10 | | become eligible
for such Medicare coverage on or after July 1, | 11 | | 1992; or (2) are
Medicare-eligible members or dependents of a | 12 | | local government unit which began
participation in the program | 13 | | on or after July 1, 1992; or (3) remain eligible
for, but no | 14 | | longer receive Medicare coverage which they had been receiving | 15 | | on
or after July 1, 1992. The Department may determine the | 16 | | aggregate level of the
State's contribution on the basis of | 17 | | actual cost of medical services adjusted
for age, sex or | 18 | | geographic or other demographic characteristics which affect
| 19 | | the costs of such programs.
| 20 | | The cost of participation in the basic program of group | 21 | | health benefits
for the dependent or survivor of a living or | 22 | | deceased retired employee who was
formerly employed by the | 23 | | University of Illinois in the Cooperative Extension
Service and | 24 | | would be an annuitant but for the fact that he or she was made
| 25 | | ineligible to participate in the State Universities Retirement | 26 | | System by clause
(4) of subsection (a) of Section 15-107 of the |
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| 1 | | Illinois Pension Code shall not
be greater than the cost of | 2 | | participation that would otherwise apply to that
dependent or | 3 | | survivor if he or she were the dependent or survivor of an
| 4 | | annuitant under the State Universities Retirement System.
| 5 | | (a-1) (Blank).
| 6 | | (a-2) (Blank).
| 7 | | (a-3) (Blank).
| 8 | | (a-4) (Blank).
| 9 | | (a-5) (Blank).
| 10 | | (a-6) (Blank).
| 11 | | (a-7) (Blank).
| 12 | | (a-8) Any annuitant, survivor, or retired employee may | 13 | | waive or terminate coverage in
the program of group health | 14 | | benefits. Any such annuitant, survivor, or retired employee
who | 15 | | has waived or terminated coverage may enroll or re-enroll in | 16 | | the
program of group health benefits only during the annual | 17 | | benefit choice period,
as determined by the Director . In ; | 18 | | except that in the event of termination of
coverage due to | 19 | | nonpayment of premiums, the annuitant, survivor, or retired | 20 | | employee
may not re-enroll in the program , except as otherwise | 21 | | provided in subsection (a-8.3) .
| 22 | | (a-8.3) Beginning on the effective date of this amendatory | 23 | | Act of the 101st General Assembly, an annuitant, survivor, or | 24 | | retired employee whose coverage has been terminated for | 25 | | nonpayment of premiums between January 1, 2018 and January 1, | 26 | | 2019 may re-enroll in the program during the next annual |
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| 1 | | benefit choice period, as determined by the Director, if he or | 2 | | she has fully paid all previous nonpayments prior to that | 3 | | re-enrollment. This subsection (a-8.3) is inoperative on and | 4 | | after January 1, 2021. | 5 | | (a-8.5) Beginning on the effective date of this amendatory | 6 | | Act of the 97th General Assembly, the Director of Central | 7 | | Management Services shall, on an annual basis, determine the | 8 | | amount that the State shall contribute toward the basic program | 9 | | of group health benefits on behalf of annuitants (including | 10 | | individuals who (i) participated in the General Assembly | 11 | | Retirement System, the State Employees' Retirement System of | 12 | | Illinois, the State Universities Retirement System, the | 13 | | Teachers' Retirement System of the State of Illinois, or the | 14 | | Judges Retirement System of Illinois and (ii) qualify as | 15 | | annuitants under subsection (b) of Section 3 of this Act), | 16 | | survivors (including individuals who (i) receive an annuity as | 17 | | a survivor of an individual who participated in the General | 18 | | Assembly Retirement System, the State Employees' Retirement | 19 | | System of Illinois, the State Universities Retirement System, | 20 | | the Teachers' Retirement System of the State of Illinois, or | 21 | | the Judges Retirement System of Illinois and (ii) qualify as | 22 | | survivors under subsection (q) of Section 3 of this Act), and | 23 | | retired employees (as defined in subsection (p) of Section 3 of | 24 | | this Act). The remainder of the cost of coverage for each | 25 | | annuitant, survivor, or retired employee, as determined by the | 26 | | Director of Central Management Services, shall be the |
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| 1 | | responsibility of that annuitant, survivor, or retired | 2 | | employee. | 3 | | Contributions required of annuitants, survivors, and | 4 | | retired employees shall be the same for all retirement systems | 5 | | and shall also be based on whether an individual has made an | 6 | | election under Section 15-135.1 of the Illinois Pension Code. | 7 | | Contributions may be based on annuitants', survivors', or | 8 | | retired employees' Medicare eligibility, but may not be based | 9 | | on Social Security eligibility. | 10 | | (a-9) No later than May 1 of each calendar year, the | 11 | | Director
of Central Management Services shall certify in | 12 | | writing to the Executive
Secretary of the State Employees' | 13 | | Retirement System of Illinois the amounts
of the Medicare | 14 | | supplement health care premiums and the amounts of the
health | 15 | | care premiums for all other retirees who are not Medicare | 16 | | eligible.
| 17 | | A separate calculation of the premiums based upon the | 18 | | actual cost of each
health care plan shall be so certified.
| 19 | | The Director of Central Management Services shall provide | 20 | | to the
Executive Secretary of the State Employees' Retirement | 21 | | System of
Illinois such information, statistics, and other data | 22 | | as he or she
may require to review the premium amounts | 23 | | certified by the Director
of Central Management Services.
| 24 | | The Department of Central Management Services, or any | 25 | | successor agency designated to procure healthcare contracts | 26 | | pursuant to this Act, is authorized to establish funds, |
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| 1 | | separate accounts provided by any bank or banks as defined by | 2 | | the Illinois Banking Act, or separate accounts provided by any | 3 | | savings and loan association or associations as defined by the | 4 | | Illinois Savings and Loan Act of 1985 to be held by the | 5 | | Director, outside the State treasury, for the purpose of | 6 | | receiving the transfer of moneys from the Local Government | 7 | | Health Insurance Reserve Fund. The Department may promulgate | 8 | | rules further defining the methodology for the transfers. Any | 9 | | interest earned by moneys in the funds or accounts shall inure | 10 | | to the Local Government Health Insurance Reserve Fund. The | 11 | | transferred moneys, and interest accrued thereon, shall be used | 12 | | exclusively for transfers to administrative service | 13 | | organizations or their financial institutions for payments of | 14 | | claims to claimants and providers under the self-insurance | 15 | | health plan. The transferred moneys, and interest accrued | 16 | | thereon, shall not be used for any other purpose including, but | 17 | | not limited to, reimbursement of administration fees due the | 18 | | administrative service organization pursuant to its contract | 19 | | or contracts with the Department.
| 20 | | (a-10) To the extent that participation, benefits, or | 21 | | premiums under this Act are based on a person's service credit | 22 | | under an Article of the Illinois Pension Code, service credit | 23 | | terminated in exchange for an accelerated pension benefit | 24 | | payment under Section 14-147.5, 15-185.5, or 16-190.5 of that | 25 | | Code shall be included in determining a person's service credit | 26 | | for the purposes of this Act. |
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| 1 | | (b) State employees who become eligible for this program on | 2 | | or after January
1, 1980 in positions normally requiring actual | 3 | | performance of duty not less
than 1/2 of a normal work period | 4 | | but not equal to that of a normal work period,
shall be given | 5 | | the option of participating in the available program. If the
| 6 | | employee elects coverage, the State shall contribute on behalf | 7 | | of such employee
to the cost of the employee's benefit and any | 8 | | applicable dependent supplement,
that sum which bears the same | 9 | | percentage as that percentage of time the
employee regularly | 10 | | works when compared to normal work period.
| 11 | | (c) The basic non-contributory coverage from the basic | 12 | | program of
group health benefits shall be continued for each | 13 | | employee not in pay status or
on active service by reason of | 14 | | (1) leave of absence due to illness or injury,
(2) authorized | 15 | | educational leave of absence or sabbatical leave, or (3)
| 16 | | military leave. This coverage shall continue until
expiration | 17 | | of authorized leave and return to active service, but not to | 18 | | exceed
24 months for leaves under item (1) or (2). This | 19 | | 24-month limitation and the
requirement of returning to active | 20 | | service shall not apply to persons receiving
ordinary or | 21 | | accidental disability benefits or retirement benefits through | 22 | | the
appropriate State retirement system or benefits under the | 23 | | Workers' Compensation
or Occupational Disease Act.
| 24 | | (d) The basic group life insurance coverage shall continue, | 25 | | with
full State contribution, where such person is (1) absent | 26 | | from active
service by reason of disability arising from any |
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| 1 | | cause other than
self-inflicted, (2) on authorized educational | 2 | | leave of absence or
sabbatical leave, or (3) on military leave.
| 3 | | (e) Where the person is in non-pay status for a period in | 4 | | excess of
30 days or on leave of absence, other than by reason | 5 | | of disability,
educational or sabbatical leave, or military | 6 | | leave, such
person may continue coverage only by making | 7 | | personal
payment equal to the amount normally contributed by | 8 | | the State on such person's
behalf. Such payments and coverage | 9 | | may be continued: (1) until such time as
the person returns to | 10 | | a status eligible for coverage at State expense, but not
to | 11 | | exceed 24 months or (2) until such person's employment or | 12 | | annuitant status
with the State is terminated (exclusive of any | 13 | | additional service imposed pursuant to law).
| 14 | | (f) The Department shall establish by rule the extent to | 15 | | which other
employee benefits will continue for persons in | 16 | | non-pay status or who are
not in active service.
| 17 | | (g) The State shall not pay the cost of the basic | 18 | | non-contributory
group life insurance, program of health | 19 | | benefits and other employee benefits
for members who are | 20 | | survivors as defined by paragraphs (1) and (2) of
subsection | 21 | | (q) of Section 3 of this Act. The costs of benefits for these
| 22 | | survivors shall be paid by the survivors or by the University | 23 | | of Illinois
Cooperative Extension Service, or any combination | 24 | | thereof.
However, the State shall pay the amount of the | 25 | | reduction in the cost of
participation, if any, resulting from | 26 | | the amendment to subsection (a) made
by this amendatory Act of |
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| 1 | | the 91st General Assembly.
| 2 | | (h) Those persons occupying positions with any department | 3 | | as a result
of emergency appointments pursuant to Section 8b.8 | 4 | | of the Personnel Code
who are not considered employees under | 5 | | this Act shall be given the option
of participating in the | 6 | | programs of group life insurance, health benefits and
other | 7 | | employee benefits. Such persons electing coverage may | 8 | | participate only
by making payment equal to the amount normally | 9 | | contributed by the State for
similarly situated employees. Such | 10 | | amounts shall be determined by the
Director. Such payments and | 11 | | coverage may be continued until such time as the
person becomes | 12 | | an employee pursuant to this Act or such person's appointment | 13 | | is
terminated.
| 14 | | (i) Any unit of local government within the State of | 15 | | Illinois
may apply to the Director to have its employees, | 16 | | annuitants, and their
dependents provided group health | 17 | | coverage under this Act on a non-insured
basis. To participate, | 18 | | a unit of local government must agree to enroll
all of its | 19 | | employees, who may select coverage under either the State group
| 20 | | health benefits plan or a health maintenance organization that | 21 | | has
contracted with the State to be available as a health care | 22 | | provider for
employees as defined in this Act. A unit of local | 23 | | government must remit the
entire cost of providing coverage | 24 | | under the State group health benefits plan
or, for coverage | 25 | | under a health maintenance organization, an amount determined
| 26 | | by the Director based on an analysis of the sex, age, |
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| 1 | | geographic location, or
other relevant demographic variables | 2 | | for its employees, except that the unit of
local government | 3 | | shall not be required to enroll those of its employees who are
| 4 | | covered spouses or dependents under this plan or another group | 5 | | policy or plan
providing health benefits as long as (1) an | 6 | | appropriate official from the unit
of local government attests | 7 | | that each employee not enrolled is a covered spouse
or | 8 | | dependent under this plan or another group policy or plan, and | 9 | | (2) at least
50% of the employees are enrolled and the unit of | 10 | | local government remits
the entire cost of providing coverage | 11 | | to those employees, except that a
participating school district | 12 | | must have enrolled at least 50% of its full-time
employees who | 13 | | have not waived coverage under the district's group health
plan | 14 | | by participating in a component of the district's cafeteria | 15 | | plan. A
participating school district is not required to enroll | 16 | | a full-time employee
who has waived coverage under the | 17 | | district's health plan, provided that an
appropriate official | 18 | | from the participating school district attests that the
| 19 | | full-time employee has waived coverage by participating in a | 20 | | component of the
district's cafeteria plan. For the purposes of | 21 | | this subsection, "participating
school district" includes a | 22 | | unit of local government whose primary purpose is
education as | 23 | | defined by the Department's rules.
| 24 | | Employees of a participating unit of local government who | 25 | | are not enrolled
due to coverage under another group health | 26 | | policy or plan may enroll in
the event of a qualifying change |
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| 1 | | in status, special enrollment, special
circumstance as defined | 2 | | by the Director, or during the annual Benefit Choice
Period. A | 3 | | participating unit of local government may also elect to cover | 4 | | its
annuitants. Dependent coverage shall be offered on an | 5 | | optional basis, with the
costs paid by the unit of local | 6 | | government, its employees, or some combination
of the two as | 7 | | determined by the unit of local government. The unit of local
| 8 | | government shall be responsible for timely collection and | 9 | | transmission of
dependent premiums.
| 10 | | The Director shall annually determine monthly rates of | 11 | | payment, subject
to the following constraints:
| 12 | | (1) In the first year of coverage, the rates shall be | 13 | | equal to the
amount normally charged to State employees for | 14 | | elected optional coverages
or for enrolled dependents | 15 | | coverages or other contributory coverages, or
contributed | 16 | | by the State for basic insurance coverages on behalf of its
| 17 | | employees, adjusted for differences between State | 18 | | employees and employees
of the local government in age, | 19 | | sex, geographic location or other relevant
demographic | 20 | | variables, plus an amount sufficient to pay for the | 21 | | additional
administrative costs of providing coverage to | 22 | | employees of the unit of
local government and their | 23 | | 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 unit of
local government.
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| 1 | | In the case of coverage of local government employees under | 2 | | a health
maintenance organization, the Director shall annually | 3 | | determine for each
participating unit of local government the | 4 | | maximum monthly amount the unit
may contribute toward that | 5 | | coverage, based on an analysis of (i) the age,
sex, geographic | 6 | | location, and other relevant demographic variables of the
| 7 | | unit's employees and (ii) the cost to cover those employees | 8 | | under the State
group health benefits plan. The Director may | 9 | | similarly determine the
maximum monthly amount each unit of | 10 | | local government may contribute toward
coverage of its | 11 | | employees' dependents under a health maintenance organization.
| 12 | | Monthly payments by the unit of local government or its | 13 | | employees for
group health benefits plan or health maintenance | 14 | | organization coverage shall
be deposited in the Local | 15 | | Government Health Insurance Reserve Fund.
| 16 | | The Local Government Health Insurance Reserve Fund is | 17 | | hereby created as a nonappropriated trust fund to be held | 18 | | outside the State Treasury, with the State Treasurer as | 19 | | custodian. The Local Government Health Insurance Reserve Fund | 20 | | shall be a continuing
fund not subject to fiscal year | 21 | | limitations. The Local Government Health Insurance Reserve | 22 | | Fund is not subject to administrative charges or charge-backs, | 23 | | including but not limited to those authorized under Section 8h | 24 | | of the State Finance Act. All revenues arising from the | 25 | | administration of the health benefits program established | 26 | | under this Section shall be deposited into the Local Government |
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| 1 | | Health Insurance Reserve Fund. Any interest earned on moneys in | 2 | | the Local Government Health Insurance Reserve Fund shall be | 3 | | deposited into the Fund. All expenditures from this Fund
shall | 4 | | be used for payments for health care benefits for local | 5 | | government and rehabilitation facility
employees, annuitants, | 6 | | and dependents, and to reimburse the Department or
its | 7 | | administrative service organization for all expenses incurred | 8 | | in the
administration of benefits. No other State funds may be | 9 | | used for these
purposes.
| 10 | | A local government employer's participation or desire to | 11 | | participate
in a program created under this subsection shall | 12 | | not limit that employer's
duty to bargain with the | 13 | | representative of any collective bargaining unit
of its | 14 | | employees.
| 15 | | (j) Any rehabilitation facility within the State of | 16 | | Illinois may apply
to the Director to have its employees, | 17 | | annuitants, and their eligible
dependents provided group | 18 | | health coverage under this Act on a non-insured
basis. To | 19 | | participate, a rehabilitation facility must agree to enroll all
| 20 | | of its employees and remit the entire cost of providing such | 21 | | coverage for
its employees, except that the rehabilitation | 22 | | facility shall not be
required to enroll those of its employees | 23 | | who are covered spouses or
dependents under this plan or | 24 | | another group policy or plan providing health
benefits as long | 25 | | as (1) an appropriate official from the rehabilitation
facility | 26 | | attests that each employee not enrolled is a covered spouse or
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| 1 | | dependent under this plan or another group policy or plan, and | 2 | | (2) at least
50% of the employees are enrolled and the | 3 | | rehabilitation facility remits
the entire cost of providing | 4 | | coverage to those employees. Employees of a
participating | 5 | | rehabilitation facility who are not enrolled due to coverage
| 6 | | under another group health policy or plan may enroll
in the | 7 | | event of a qualifying change in status, special enrollment, | 8 | | special
circumstance as defined by the Director, or during the | 9 | | annual Benefit Choice
Period. A participating rehabilitation | 10 | | facility may also elect
to cover its annuitants. Dependent | 11 | | coverage shall be offered on an optional
basis, with the costs | 12 | | paid by the rehabilitation facility, its employees, or
some | 13 | | combination of the 2 as determined by the rehabilitation | 14 | | facility. The
rehabilitation facility shall be responsible for | 15 | | timely collection and
transmission of dependent premiums.
| 16 | | The Director shall annually determine quarterly 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 on behalf of
its | 22 | | employees, adjusted for differences between State | 23 | | employees and
employees of the rehabilitation facility in | 24 | | age, sex, geographic location
or other relevant | 25 | | demographic variables, plus an amount sufficient to pay
for | 26 | | the additional administrative costs of providing coverage |
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| 1 | | to employees
of the rehabilitation facility and their | 2 | | dependents.
| 3 | | (2) In subsequent years, a further adjustment shall be | 4 | | made to reflect
the actual prior years' claims experience | 5 | | of the employees of the
rehabilitation facility.
| 6 | | Monthly payments by the rehabilitation facility or its | 7 | | employees for
group health benefits shall be deposited in the | 8 | | Local Government Health
Insurance Reserve Fund.
| 9 | | (k) Any domestic violence shelter or service within the | 10 | | State of Illinois
may apply to the Director to have its | 11 | | employees, annuitants, and their
dependents provided group | 12 | | health coverage under this Act on a non-insured
basis. To | 13 | | participate, a domestic violence shelter or service must agree | 14 | | to
enroll all of its employees and pay the entire cost of | 15 | | providing such coverage
for its employees. The domestic | 16 | | violence shelter shall not be required to enroll those of its | 17 | | employees who are covered spouses or dependents under this plan | 18 | | or another group policy or plan providing health benefits as | 19 | | long as (1) an appropriate official from the domestic violence | 20 | | shelter attests that each employee not enrolled is a covered | 21 | | spouse or dependent under this plan or another group policy or | 22 | | plan and (2) at least 50% of the employees are enrolled and the | 23 | | domestic violence shelter remits the entire cost of providing | 24 | | coverage to those employees. Employees of a participating | 25 | | domestic violence shelter who are not enrolled due to coverage | 26 | | under another group health policy or plan may enroll in the |
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| 1 | | event of a qualifying change in status, special enrollment, or | 2 | | special circumstance as defined by the Director or during the | 3 | | annual Benefit Choice Period. A participating domestic | 4 | | violence shelter may also elect
to cover its annuitants. | 5 | | Dependent coverage shall be offered on an optional
basis, with
| 6 | | employees, or some combination of the 2 as determined by the | 7 | | domestic violence
shelter or service. The domestic violence | 8 | | shelter or service shall be
responsible for timely collection | 9 | | and transmission of dependent premiums.
| 10 | | The Director shall annually determine rates of payment,
| 11 | | subject to the following constraints:
| 12 | | (1) In the first year of coverage, the rates shall be | 13 | | equal to the
amount normally charged to State employees for | 14 | | elected optional coverages
or for enrolled dependents | 15 | | coverages or other contributory coverages on
behalf of its | 16 | | employees, adjusted for differences between State | 17 | | employees and
employees of the domestic violence shelter or | 18 | | service in age, sex, geographic
location or other relevant | 19 | | demographic variables, plus an amount sufficient
to pay for | 20 | | the additional administrative costs of providing coverage | 21 | | to
employees of the domestic violence shelter or service | 22 | | and their dependents.
| 23 | | (2) In subsequent years, a further adjustment shall be | 24 | | made to reflect
the actual prior years' claims experience | 25 | | of the employees of the domestic
violence shelter or | 26 | | service.
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| 1 | | Monthly payments by the domestic violence shelter or | 2 | | service or its employees
for group health insurance shall be | 3 | | deposited in the Local Government Health
Insurance Reserve | 4 | | Fund.
| 5 | | (l) A public community college or entity organized pursuant | 6 | | to the
Public Community College Act may apply to the Director | 7 | | initially to have
only annuitants not covered prior to July 1, | 8 | | 1992 by the district's health
plan provided health coverage | 9 | | under this Act on a non-insured basis. The
community college | 10 | | must execute a 2-year contract to participate in the
Local | 11 | | Government Health Plan.
Any annuitant may enroll in the event | 12 | | of a qualifying change in status, special
enrollment, special | 13 | | circumstance as defined by the Director, or during the
annual | 14 | | Benefit Choice Period.
| 15 | | The Director shall annually determine monthly rates of | 16 | | payment subject to
the following constraints: for those | 17 | | community colleges with annuitants
only enrolled, first year | 18 | | rates shall be equal to the average cost to cover
claims for a | 19 | | State member adjusted for demographics, Medicare
| 20 | | participation, and other factors; and in the second year, a | 21 | | further adjustment
of rates shall be made to reflect the actual | 22 | | first year's claims experience
of the covered annuitants.
| 23 | | (l-5) The provisions of subsection (l) become inoperative | 24 | | on July 1, 1999.
| 25 | | (m) The Director shall adopt any rules deemed necessary for
| 26 | | implementation of this amendatory Act of 1989 (Public Act |
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| 1 | | 86-978).
| 2 | | (n) Any child advocacy center within the State of Illinois | 3 | | may apply to the Director to have its employees, annuitants, | 4 | | and their dependents provided group health coverage under this | 5 | | Act on a non-insured basis. To participate, a child advocacy | 6 | | center must agree to enroll all of its employees and pay the | 7 | | entire cost of providing coverage for its employees. The child
| 8 | | advocacy center shall not be required to enroll those of its
| 9 | | employees who are covered spouses or dependents under this plan
| 10 | | or another group policy or plan providing health benefits as
| 11 | | long as (1) an appropriate official from the child advocacy
| 12 | | center attests that each employee not enrolled is a covered
| 13 | | spouse or dependent under this plan or another group policy or
| 14 | | plan and (2) at least 50% of the employees are enrolled and the | 15 | | child advocacy center remits the entire cost of providing | 16 | | coverage to those employees. Employees of a participating child | 17 | | advocacy center who are not enrolled due to coverage under | 18 | | another group health policy or plan may enroll in the event of | 19 | | a qualifying change in status, special enrollment, or special | 20 | | circumstance as defined by the Director or during the annual | 21 | | Benefit Choice Period. A participating child advocacy center | 22 | | may also elect to cover its annuitants. Dependent coverage | 23 | | shall be offered on an optional basis, with the costs paid by | 24 | | the child advocacy center, its employees, or some combination | 25 | | of the 2 as determined by the child advocacy center. The child | 26 | | advocacy center shall be responsible for timely collection and |
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| 1 | | transmission of dependent premiums. | 2 | | The Director shall annually determine rates of payment, | 3 | | subject to the following constraints: | 4 | | (1) In the first year of coverage, the rates shall be | 5 | | equal to the amount normally charged to State employees for | 6 | | elected optional coverages or for enrolled dependents | 7 | | coverages or other contributory coverages on behalf of its | 8 | | employees, adjusted for differences between State | 9 | | employees and employees of the child advocacy center in | 10 | | age, sex, geographic location, or other relevant | 11 | | demographic variables, plus an amount sufficient to pay for | 12 | | the additional administrative costs of providing coverage | 13 | | to employees of the child advocacy center and their | 14 | | dependents. | 15 | | (2) In subsequent years, a further adjustment shall be | 16 | | made to reflect the actual prior years' claims experience | 17 | | of the employees of the child advocacy center. | 18 | | Monthly payments by the child advocacy center or its | 19 | | employees for group health insurance shall be deposited into | 20 | | the Local Government Health Insurance Reserve Fund. | 21 | | (Source: P.A. 100-587, eff. 6-4-18.)".
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