Full Text of HB6177 97th General Assembly
HB6177 97TH GENERAL ASSEMBLY |
| | 97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012 HB6177 Introduced , by Rep. Karen May SYNOPSIS AS INTRODUCED: |
| 5 ILCS 375/3 | from Ch. 127, par. 523 | 5 ILCS 375/6.5 | | 5 ILCS 375/6.9 | | 5 ILCS 375/10 | from Ch. 127, par. 530 |
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Amends the State Employees Group Insurance Act of 1971. Deletes the following defined terms: "New SERS annuitant", "New SURS annuitant", "New TRS State annuitant", "New SERS survivor", "New SURS survivor", and "New TRS State survivor". Deletes provisions that require the
State to contribute toward the cost of
coverage under the basic program of group health benefits an amount that is equal
to 5% of that cost for each full year of creditable service, up to a maximum of 100% for an
annuitant with 20 or more years of creditable service, for those classes of persons. Changes the manner in which the cost of health benefits for community college benefit recipients and TRS benefit recipients is to be paid. Provides that, beginning on the effective date of the amendatory Act, the Director of Central Management Services shall, on an annual basis, determine the amount that each annuitant, survivor, and retired employee shall contribute toward the basic program of group health benefits on behalf of retired employees, annuitants, and survivors. Requires the Director, when determining that amount, to take into account benefit points and annual pension income. Sets the amount of the required State contribution toward the basic program of group health benefits. Effective July 1, 2012.
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| | | FISCAL NOTE ACT MAY APPLY | |
| | A BILL FOR |
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| 1 | | AN ACT concerning government.
| 2 | | Be it enacted by the People of the State of Illinois,
| 3 | | represented in the General Assembly:
| 4 | | Section 5. The State Employees Group Insurance Act of 1971 | 5 | | is amended by changing Sections 3, 6.5, 6.9, and 10 as follows:
| 6 | | (5 ILCS 375/3) (from Ch. 127, par. 523)
| 7 | | Sec. 3. Definitions. Unless the context otherwise | 8 | | requires, the
following words and phrases as used in this Act | 9 | | shall have the following
meanings. The Department may define | 10 | | these and other words and phrases
separately for the purpose of | 11 | | implementing specific programs providing benefits
under this | 12 | | Act.
| 13 | | (a) "Administrative service organization" means any | 14 | | person, firm or
corporation experienced in the handling of | 15 | | claims which is
fully qualified, financially sound and capable | 16 | | of meeting the service
requirements of a contract of | 17 | | administration executed with the Department.
| 18 | | (b) "Annuitant" means (1) an employee who retires, or has | 19 | | retired,
on or after January 1, 1966 on an immediate annuity | 20 | | under the provisions
of Articles 2, 14 (including an employee | 21 | | who has elected to receive an alternative retirement | 22 | | cancellation payment under Section 14-108.5 of the Illinois | 23 | | Pension Code in lieu of an annuity), 15 (including an employee |
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| 1 | | who has retired under the optional
retirement program | 2 | | established under Section 15-158.2),
paragraphs (2), (3), or | 3 | | (5) of Section 16-106, or
Article 18 of the Illinois Pension | 4 | | Code; (2) any person who was receiving
group insurance coverage | 5 | | under this Act as of March 31, 1978 by
reason of his status as | 6 | | an annuitant, even though the annuity in relation
to which such | 7 | | coverage was provided is a proportional annuity based on less
| 8 | | than the minimum period of service required for a retirement | 9 | | annuity in
the system involved; (3) any person not otherwise | 10 | | covered by this Act
who has retired as a participating member | 11 | | under Article 2 of the Illinois
Pension Code but is ineligible | 12 | | for the retirement annuity under Section
2-119 of the Illinois | 13 | | Pension Code; (4) the spouse of any person who
is receiving a | 14 | | retirement annuity under Article 18 of the Illinois Pension
| 15 | | Code and who is covered under a group health insurance program | 16 | | sponsored
by a governmental employer other than the State of | 17 | | Illinois and who has
irrevocably elected to waive his or her | 18 | | coverage under this Act and to have
his or her spouse | 19 | | considered as the "annuitant" under this Act and not as
a | 20 | | "dependent"; or (5) an employee who retires, or has retired, | 21 | | from a
qualified position, as determined according to rules | 22 | | promulgated by the
Director, under a qualified local | 23 | | government, a qualified rehabilitation
facility, a qualified | 24 | | domestic violence shelter or service, or a qualified child | 25 | | advocacy center. (For definition
of "retired employee", see (p) | 26 | | post).
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| 1 | | (b-5) (Blank). "New SERS annuitant" means a person who, on | 2 | | or after January 1,
1998, becomes an annuitant, as defined in | 3 | | subsection (b), by virtue of
beginning to receive a retirement | 4 | | annuity under Article 14 of the Illinois
Pension Code | 5 | | (including an employee who has elected to receive an | 6 | | alternative retirement cancellation payment under Section | 7 | | 14-108.5 of that Code in lieu of an annuity), and is eligible | 8 | | to participate in the basic program of group
health benefits | 9 | | provided for annuitants under this Act.
| 10 | | (b-6) (Blank). "New SURS annuitant" means a person who (1) | 11 | | on or after January 1,
1998, becomes an annuitant, as defined | 12 | | in subsection (b), by virtue of
beginning to receive a | 13 | | retirement annuity under Article 15 of the Illinois
Pension | 14 | | Code, (2) has not made the election authorized under Section | 15 | | 15-135.1
of the Illinois Pension Code, and (3) is eligible to | 16 | | participate in the basic
program of group
health benefits | 17 | | provided for annuitants under this Act.
| 18 | | (b-7) (Blank). "New TRS State annuitant" means a person | 19 | | who, on or after July
1, 1998, becomes an annuitant, as defined | 20 | | in subsection (b), by virtue of
beginning to receive a | 21 | | retirement annuity under Article 16 of the Illinois
Pension | 22 | | Code based on service as a teacher as defined in
paragraph (2), | 23 | | (3), or (5) of Section 16-106 of that Code, and is eligible
to | 24 | | participate in the basic program of group health benefits | 25 | | provided for
annuitants under this Act.
| 26 | | (c) "Carrier" means (1) an insurance company, a corporation |
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| 1 | | organized
under the Limited Health Service Organization Act or | 2 | | the Voluntary Health
Services Plan Act, a partnership, or other | 3 | | nongovernmental organization,
which is authorized to do group | 4 | | life or group health insurance business in
Illinois, or (2) the | 5 | | State of Illinois as a self-insurer.
| 6 | | (d) "Compensation" means salary or wages payable on a | 7 | | regular
payroll by the State Treasurer on a warrant of the | 8 | | State Comptroller out
of any State, trust or federal fund, or | 9 | | by the Governor of the State
through a disbursing officer of | 10 | | the State out of a trust or out of
federal funds, or by any | 11 | | Department out of State, trust, federal or
other funds held by | 12 | | the State Treasurer or the Department, to any person
for | 13 | | personal services currently performed, and ordinary or | 14 | | accidental
disability benefits under Articles 2, 14, 15 | 15 | | (including ordinary or accidental
disability benefits under | 16 | | the optional retirement program established under
Section | 17 | | 15-158.2), paragraphs (2), (3), or (5) of
Section 16-106, or | 18 | | Article 18 of the Illinois Pension Code, for disability
| 19 | | incurred after January 1, 1966, or benefits payable under the | 20 | | Workers'
Compensation or Occupational Diseases Act or benefits | 21 | | payable under a sick
pay plan established in accordance with | 22 | | Section 36 of the State Finance Act.
"Compensation" also means | 23 | | salary or wages paid to an employee of any
qualified local | 24 | | government, qualified rehabilitation facility,
qualified | 25 | | domestic violence shelter or service, or qualified child | 26 | | advocacy center.
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| 1 | | (e) "Commission" means the State Employees Group Insurance | 2 | | Advisory
Commission authorized by this Act. Commencing July 1, | 3 | | 1984, "Commission"
as used in this Act means the Commission on | 4 | | Government Forecasting and Accountability as
established by | 5 | | the Legislative Commission Reorganization Act of 1984.
| 6 | | (f) "Contributory", when referred to as contributory | 7 | | coverage, shall
mean optional coverages or benefits elected by | 8 | | the member toward the cost of
which such member makes | 9 | | contribution, or which are funded in whole or in part
through | 10 | | the acceptance of a reduction in earnings or the foregoing of | 11 | | an
increase in earnings by an employee, as distinguished from | 12 | | noncontributory
coverage or benefits which are paid entirely by | 13 | | the State of Illinois
without reduction of the member's salary.
| 14 | | (g) "Department" means any department, institution, board,
| 15 | | commission, officer, court or any agency of the State | 16 | | government
receiving appropriations and having power to | 17 | | certify payrolls to the
Comptroller authorizing payments of | 18 | | salary and wages against such
appropriations as are made by the | 19 | | General Assembly from any State fund, or
against trust funds | 20 | | held by the State Treasurer and includes boards of
trustees of | 21 | | the retirement systems created by Articles 2, 14, 15, 16 and
18 | 22 | | of the Illinois Pension Code. "Department" also includes the | 23 | | Illinois
Comprehensive Health Insurance Board, the Board of | 24 | | Examiners established under
the Illinois Public Accounting | 25 | | Act, and the Illinois Finance Authority.
| 26 | | (h) "Dependent", when the term is used in the context of |
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| 1 | | the health
and life plan, means a member's spouse and any child | 2 | | (1) from
birth to age 26 including an adopted child, a child | 3 | | who lives with the
member from the time of the filing of a | 4 | | petition for adoption until entry
of an order of adoption, a | 5 | | stepchild or adjudicated child, or a child who lives with the | 6 | | member
if such member is a court appointed guardian of the | 7 | | child or (2)
age 19 or over who is mentally
or physically | 8 | | disabled from a cause originating prior to the age of 19 (age | 9 | | 26 if enrolled as an adult child dependent). For
the health | 10 | | plan only, the term "dependent" also includes (1) any person
| 11 | | enrolled prior to the effective date of this Section who is | 12 | | dependent upon
the member to the extent that the member may | 13 | | claim such person as a
dependent for income tax deduction | 14 | | purposes and (2) any person who
has received after June 30, | 15 | | 2000 an organ transplant and who is financially
dependent upon | 16 | | the member and eligible to be claimed as a dependent for income
| 17 | | tax purposes. A member requesting to cover any dependent must | 18 | | provide documentation as requested by the Department of Central | 19 | | Management Services and file with the Department any and all | 20 | | forms required by the Department.
| 21 | | (i) "Director" means the Director of the Illinois | 22 | | Department of Central
Management Services or of any successor | 23 | | agency designated to administer this Act.
| 24 | | (j) "Eligibility period" means the period of time a member | 25 | | has to
elect enrollment in programs or to select benefits | 26 | | without regard to
age, sex or health.
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| 1 | | (k) "Employee" means and includes each officer or employee | 2 | | in the
service of a department who (1) receives his | 3 | | compensation for
service rendered to the department on a | 4 | | warrant issued pursuant to a payroll
certified by a department | 5 | | or on a warrant or check issued and drawn by a
department upon | 6 | | a trust, federal or other fund or on a warrant issued
pursuant | 7 | | to a payroll certified by an elected or duly appointed officer
| 8 | | of the State or who receives payment of the performance of | 9 | | personal
services on a warrant issued pursuant to a payroll | 10 | | certified by a
Department and drawn by the Comptroller upon the | 11 | | State Treasurer against
appropriations made by the General | 12 | | Assembly from any fund or against
trust funds held by the State | 13 | | Treasurer, and (2) is employed full-time or
part-time in a | 14 | | position normally requiring actual performance of duty
during | 15 | | not less than 1/2 of a normal work period, as established by | 16 | | the
Director in cooperation with each department, except that | 17 | | persons elected
by popular vote will be considered employees | 18 | | during the entire
term for which they are elected regardless of | 19 | | hours devoted to the
service of the State, and (3) except that | 20 | | "employee" does not include any
person who is not eligible by | 21 | | reason of such person's employment to
participate in one of the | 22 | | State retirement systems under Articles 2, 14, 15
(either the | 23 | | regular Article 15 system or the optional retirement program
| 24 | | established under Section 15-158.2) or 18, or under paragraph | 25 | | (2), (3), or
(5) of Section 16-106, of the Illinois
Pension | 26 | | Code, but such term does include persons who are employed |
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| 1 | | during
the 6 month qualifying period under Article 14 of the | 2 | | Illinois Pension
Code. Such term also includes any person who | 3 | | (1) after January 1, 1966,
is receiving ordinary or accidental | 4 | | disability benefits under Articles
2, 14, 15 (including | 5 | | ordinary or accidental disability benefits under the
optional | 6 | | retirement program established under Section 15-158.2), | 7 | | paragraphs
(2), (3), or (5) of Section 16-106, or Article 18 of | 8 | | the
Illinois Pension Code, for disability incurred after | 9 | | January 1, 1966, (2)
receives total permanent or total | 10 | | temporary disability under the Workers'
Compensation Act or | 11 | | Occupational Disease Act as a result of injuries
sustained or | 12 | | illness contracted in the course of employment with the
State | 13 | | of Illinois, or (3) is not otherwise covered under this Act and | 14 | | has
retired as a participating member under Article 2 of the | 15 | | Illinois Pension
Code but is ineligible for the retirement | 16 | | annuity under Section 2-119 of
the Illinois Pension Code. | 17 | | However, a person who satisfies the criteria
of the foregoing | 18 | | definition of "employee" except that such person is made
| 19 | | ineligible to participate in the State Universities Retirement | 20 | | System by
clause (4) of subsection (a) of Section 15-107 of the | 21 | | Illinois Pension
Code is also an "employee" for the purposes of | 22 | | this Act. "Employee" also
includes any person receiving or | 23 | | eligible for benefits under a sick pay
plan established in | 24 | | accordance with Section 36 of the State Finance Act.
"Employee" | 25 | | also includes (i) each officer or employee in the service of a
| 26 | | qualified local government, including persons appointed as |
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| 1 | | trustees of
sanitary districts regardless of hours devoted to | 2 | | the service of the
sanitary district, (ii) each employee in the | 3 | | service of a qualified
rehabilitation facility, (iii) each | 4 | | full-time employee in the service of a
qualified domestic | 5 | | violence shelter or service, and (iv) each full-time employee | 6 | | in the service of a qualified child advocacy center, as | 7 | | determined according to
rules promulgated by the Director.
| 8 | | (l) "Member" means an employee, annuitant, retired | 9 | | employee or survivor. In the case of an annuitant or retired | 10 | | employee who first becomes an annuitant or retired employee on | 11 | | or after the effective date of this amendatory Act of the 97th | 12 | | General Assembly, the individual must meet the minimum vesting | 13 | | requirements of the applicable retirement system in order to be | 14 | | eligible for group insurance benefits under that system. In the | 15 | | case of a survivor who first becomes a survivor on or after the | 16 | | effective date of this amendatory Act of the 97th General | 17 | | Assembly, the deceased employee, annuitant, or retired | 18 | | employee upon whom the annuity is based must have been eligible | 19 | | to participate in the group insurance system under the | 20 | | applicable retirement system in order for the survivor to be | 21 | | eligible for group insurance benefits under that system.
| 22 | | (m) "Optional coverages or benefits" means those coverages | 23 | | or
benefits available to the member on his or her voluntary | 24 | | election, and at
his or her own expense.
| 25 | | (n) "Program" means the group life insurance, health | 26 | | benefits and other
employee benefits designed and contracted |
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| 1 | | for by the Director under this Act.
| 2 | | (o) "Health plan" means a health benefits
program offered
| 3 | | by the State of Illinois for persons eligible for the plan.
| 4 | | (p) "Retired employee" means any person who would be an | 5 | | annuitant as
that term is defined herein but for the fact that | 6 | | such person retired prior to
January 1, 1966. Such term also | 7 | | includes any person formerly employed by
the University of | 8 | | Illinois in the Cooperative Extension Service who would
be an | 9 | | annuitant but for the fact that such person was made ineligible | 10 | | to
participate in the State Universities Retirement System by | 11 | | clause (4) of
subsection (a) of Section 15-107 of the Illinois
| 12 | | Pension Code.
| 13 | | (q) "Survivor" means a person receiving an annuity as a | 14 | | survivor of an
employee or of an annuitant. "Survivor" also | 15 | | includes: (1) the surviving
dependent of a person who satisfies | 16 | | the definition of "employee" except that
such person is made | 17 | | ineligible to participate in the State Universities
Retirement | 18 | | System by clause (4) of subsection (a)
of Section 15-107 of the | 19 | | Illinois Pension Code; (2) the surviving
dependent of any | 20 | | person formerly employed by the University of Illinois in
the | 21 | | Cooperative Extension Service who would be an annuitant except | 22 | | for the
fact that such person was made ineligible to | 23 | | participate in the State
Universities Retirement System by | 24 | | clause (4) of subsection (a) of Section
15-107 of the Illinois | 25 | | Pension Code; and (3) the surviving dependent of a person who | 26 | | was an annuitant under this Act by virtue of receiving an |
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| 1 | | alternative retirement cancellation payment under Section | 2 | | 14-108.5 of the Illinois Pension Code.
| 3 | | (q-2) "SERS" means the State Employees' Retirement System | 4 | | of Illinois, created under Article 14 of the Illinois Pension | 5 | | Code.
| 6 | | (q-3) "SURS" means the State Universities Retirement | 7 | | System, created under Article 15 of the Illinois Pension Code.
| 8 | | (q-4) "TRS" means the Teachers' Retirement System of the | 9 | | State of Illinois, created under Article 16 of the Illinois | 10 | | Pension Code.
| 11 | | (q-5) (Blank). "New SERS survivor" means a survivor, as | 12 | | defined in subsection (q),
whose annuity is paid under Article | 13 | | 14 of the Illinois Pension Code and is
based on the death of | 14 | | (i) an employee whose death occurs on or after January 1,
1998, | 15 | | or (ii) a new SERS annuitant as defined in subsection (b-5). | 16 | | "New SERS survivor" includes the surviving dependent of a | 17 | | person who was an annuitant under this Act by virtue of | 18 | | receiving an alternative retirement cancellation payment under | 19 | | Section 14-108.5 of the Illinois Pension Code.
| 20 | | (q-6) (Blank). "New SURS survivor" means a survivor, as | 21 | | defined in subsection (q),
whose annuity is paid under Article | 22 | | 15 of the Illinois Pension Code and is
based on the death of | 23 | | (i) an employee whose death occurs on or after January 1,
1998, | 24 | | or (ii) a new SURS annuitant as defined in subsection (b-6).
| 25 | | (q-7) (Blank). "New TRS State survivor" means a survivor, | 26 | | as defined in subsection
(q), whose annuity is paid under |
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| 1 | | Article 16 of the Illinois Pension Code and is
based on the | 2 | | death of (i) an employee who is a teacher as defined in | 3 | | paragraph
(2), (3), or (5) of Section 16-106 of that Code and | 4 | | whose death occurs on or
after July 1, 1998, or (ii) a new TRS | 5 | | State annuitant as defined in subsection
(b-7).
| 6 | | (r) "Medical services" means the services provided within | 7 | | the scope
of their licenses by practitioners in all categories | 8 | | licensed under the
Medical Practice Act of 1987.
| 9 | | (s) "Unit of local government" means any county, | 10 | | municipality,
township, school district (including a | 11 | | combination of school districts under
the Intergovernmental | 12 | | Cooperation Act), special district or other unit,
designated as | 13 | | a
unit of local government by law, which exercises limited | 14 | | governmental
powers or powers in respect to limited | 15 | | governmental subjects, any
not-for-profit association with a | 16 | | membership that primarily includes
townships and township | 17 | | officials, that has duties that include provision of
research | 18 | | service, dissemination of information, and other acts for the
| 19 | | purpose of improving township government, and that is funded | 20 | | wholly or
partly in accordance with Section 85-15 of the | 21 | | Township Code; any
not-for-profit corporation or association, | 22 | | with a membership consisting
primarily of municipalities, that | 23 | | operates its own utility system, and
provides research, | 24 | | training, dissemination of information, or other acts to
| 25 | | promote cooperation between and among municipalities that | 26 | | provide utility
services and for the advancement of the goals |
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| 1 | | and purposes of its
membership;
the Southern Illinois | 2 | | Collegiate Common Market, which is a consortium of higher
| 3 | | education institutions in Southern Illinois; the Illinois | 4 | | Association of
Park Districts; and any hospital provider that | 5 | | is owned by a county that has 100 or fewer hospital beds and | 6 | | has not already joined the program. "Qualified
local | 7 | | government" means a unit of local government approved by the | 8 | | Director and
participating in a program created under | 9 | | subsection (i) of Section 10 of this
Act.
| 10 | | (t) "Qualified rehabilitation facility" means any | 11 | | not-for-profit
organization that is accredited by the | 12 | | Commission on Accreditation of
Rehabilitation Facilities or | 13 | | certified by the Department
of Human Services (as successor to | 14 | | the Department of Mental Health
and Developmental | 15 | | Disabilities) to provide services to persons with
disabilities
| 16 | | and which receives funds from the State of Illinois for | 17 | | providing those
services, approved by the Director and | 18 | | participating in a program created
under subsection (j) of | 19 | | Section 10 of this Act.
| 20 | | (u) "Qualified domestic violence shelter or service" means | 21 | | any Illinois
domestic violence shelter or service and its | 22 | | administrative offices funded
by the Department of Human | 23 | | Services (as successor to the Illinois Department of
Public | 24 | | Aid),
approved by the Director and
participating in a program | 25 | | created under subsection (k) of Section 10.
| 26 | | (v) "TRS benefit recipient" means a person who:
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| 1 | | (1) is not a "member" as defined in this Section; and
| 2 | | (2) is receiving a monthly benefit or retirement | 3 | | annuity
under Article 16 of the Illinois Pension Code; and
| 4 | | (3) either (i) has at least 8 years of creditable | 5 | | service under Article
16 of the Illinois Pension Code, or | 6 | | (ii) was enrolled in the health insurance
program offered | 7 | | under that Article on January 1, 1996, or (iii) is the | 8 | | survivor
of a benefit recipient who had at least 8
years of | 9 | | creditable service under Article 16 of the Illinois Pension | 10 | | Code or
was enrolled in the health insurance program | 11 | | offered under that Article on
the effective date of this | 12 | | amendatory Act of 1995, or (iv) is a recipient or
survivor | 13 | | of a recipient of a disability benefit under Article 16 of | 14 | | the
Illinois Pension Code.
| 15 | | (w) "TRS dependent beneficiary" means a person who:
| 16 | | (1) is not a "member" or "dependent" as defined in this | 17 | | Section; and
| 18 | | (2) is a TRS benefit recipient's: (A) spouse, (B) | 19 | | dependent parent who
is receiving at least half of his or | 20 | | her support from the TRS benefit
recipient, or (C) natural, | 21 | | step, adjudicated, or adopted child who is (i) under age | 22 | | 26, (ii) was, on January 1, 1996, participating as a | 23 | | dependent
beneficiary in the health insurance program | 24 | | offered under Article 16 of the
Illinois Pension Code, or | 25 | | (iii) age 19 or over who is mentally or physically disabled | 26 | | from a cause originating prior to the age of 19 (age 26 if |
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| 1 | | enrolled as an adult child).
| 2 | | "TRS dependent beneficiary" does not include, as indicated | 3 | | under paragraph (2) of this subsection (w), a dependent of the | 4 | | survivor of a TRS benefit recipient who first becomes a | 5 | | dependent of a survivor of a TRS benefit recipient on or after | 6 | | the effective date of this amendatory Act of the 97th General | 7 | | Assembly unless that dependent would have been eligible for | 8 | | coverage as a dependent of the deceased TRS benefit recipient | 9 | | upon whom the survivor benefit is based. | 10 | | (x) "Military leave" refers to individuals in basic
| 11 | | training for reserves, special/advanced training, annual | 12 | | training, emergency
call up, activation by the President of the | 13 | | United States, or any other training or duty in service to the | 14 | | United States Armed Forces.
| 15 | | (y) (Blank).
| 16 | | (z) "Community college benefit recipient" means a person | 17 | | who:
| 18 | | (1) is not a "member" as defined in this Section; and
| 19 | | (2) is receiving a monthly survivor's annuity or | 20 | | retirement annuity
under Article 15 of the Illinois Pension | 21 | | Code; and
| 22 | | (3) either (i) was a full-time employee of a community | 23 | | college district or
an association of community college | 24 | | boards created under the Public Community
College Act | 25 | | (other than an employee whose last employer under Article | 26 | | 15 of the
Illinois Pension Code was a community college |
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| 1 | | district subject to Article VII
of the Public Community | 2 | | College Act) and was eligible to participate in a group
| 3 | | health benefit plan as an employee during the time of | 4 | | employment with a
community college district (other than a | 5 | | community college district subject to
Article VII of the | 6 | | Public Community College Act) or an association of | 7 | | community
college boards, or (ii) is the survivor of a | 8 | | person described in item (i).
| 9 | | (aa) "Community college dependent beneficiary" means a | 10 | | person who:
| 11 | | (1) is not a "member" or "dependent" as defined in this | 12 | | Section; and
| 13 | | (2) is a community college benefit recipient's: (A) | 14 | | spouse, (B) dependent
parent who is receiving at least half | 15 | | of his or her support from the community
college benefit | 16 | | recipient, or (C) natural, step, adjudicated, or adopted | 17 | | child who is (i)
under age 26, or (ii)
age 19 or over and | 18 | | mentally or physically disabled from a cause originating | 19 | | prior to the age of 19 (age 26 if enrolled as an adult | 20 | | child).
| 21 | | "Community college dependent beneficiary" does not | 22 | | include, as indicated under paragraph (2) of this subsection | 23 | | (aa), a dependent of the survivor of a community college | 24 | | benefit recipient who first becomes a dependent of a survivor | 25 | | of a community college benefit recipient on or after the | 26 | | effective date of this amendatory Act of the 97th General |
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| 1 | | Assembly unless that dependent would have been eligible for | 2 | | coverage as a dependent of the deceased community college | 3 | | benefit recipient upon whom the survivor annuity is based. | 4 | | (bb) "Qualified child advocacy center" means any Illinois | 5 | | child advocacy center and its administrative offices funded by | 6 | | the Department of Children and Family Services, as defined by | 7 | | the Children's Advocacy Center Act (55 ILCS 80/), approved by | 8 | | the Director and participating in a program created under | 9 | | subsection (n) of Section 10.
| 10 | | (Source: P.A. 96-756, eff. 1-1-10; 96-1519, eff. 2-4-11; | 11 | | 97-668, eff. 1-13-12.)
| 12 | | (5 ILCS 375/6.5)
| 13 | | Sec. 6.5. Health benefits for TRS benefit recipients and | 14 | | TRS dependent
beneficiaries. | 15 | | (a) Purpose. It is the purpose of this amendatory Act of | 16 | | 1995 to transfer
the administration of the program of health | 17 | | benefits established for benefit
recipients and their | 18 | | dependent beneficiaries under Article 16 of the Illinois
| 19 | | Pension Code to the Department of Central Management Services.
| 20 | | (b) Transition provisions. The Board of Trustees of the | 21 | | Teachers'
Retirement System shall continue to administer the | 22 | | health benefit program
established under Article 16 of the | 23 | | Illinois Pension Code through December 31,
1995. Beginning | 24 | | January 1, 1996, the Department of Central Management Services
| 25 | | shall be responsible for administering a program of health |
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| 1 | | benefits for TRS
benefit recipients and TRS dependent | 2 | | beneficiaries under this Section.
The Department of Central | 3 | | Management Services and the Teachers' Retirement
System shall | 4 | | cooperate in this endeavor and shall coordinate their | 5 | | activities
so as to ensure a smooth transition and | 6 | | uninterrupted health benefit coverage.
| 7 | | (c) Eligibility. All persons who were enrolled in the | 8 | | Article 16 program at
the time of the transfer shall be | 9 | | eligible to participate in the program
established under this | 10 | | Section without any interruption or delay in coverage
or | 11 | | limitation as to pre-existing medical conditions. Eligibility | 12 | | to
participate shall be determined by the Teachers' Retirement | 13 | | System.
Eligibility information shall be communicated to the | 14 | | Department of Central
Management Services in a format | 15 | | acceptable to the Department.
| 16 | | A TRS dependent beneficiary who is a child age 19 or over | 17 | | and
mentally or physically disabled does not become ineligible | 18 | | to participate
by reason of (i) becoming ineligible to be | 19 | | claimed as a dependent for Illinois
or federal income tax | 20 | | purposes or (ii) receiving earned income, so long as
those | 21 | | earnings are insufficient for the child to be fully | 22 | | self-sufficient.
| 23 | | (d) Coverage. The level of health benefits provided under | 24 | | this Section
shall be similar to the level of benefits provided | 25 | | by the
program previously established under Article 16 of the | 26 | | Illinois Pension Code.
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| 1 | | Group life insurance benefits are not included in the | 2 | | benefits
to be provided to TRS benefit recipients and TRS | 3 | | dependent beneficiaries under
this Act.
| 4 | | The program of health benefits under this Section may | 5 | | include any or all of
the benefit limitations, including but | 6 | | not limited to a reduction in benefits
based on eligibility for | 7 | | federal medicare benefits, that are provided under
subsection | 8 | | (a) of Section 6 of this Act for other health benefit programs | 9 | | under
this Act.
| 10 | | (e) Insurance rates and premiums. The Director shall | 11 | | determine the
insurance rates and premiums for TRS benefit | 12 | | recipients and TRS dependent
beneficiaries,
and shall present | 13 | | to the Teachers' Retirement System of
the State of Illinois, by | 14 | | April 15 of each calendar year, the rate-setting
methodology | 15 | | (including but not limited to utilization levels and costs) | 16 | | used
to determine the amount of the health care premiums.
| 17 | | For Fiscal Year 1996, the premium shall be equal to the | 18 | | premium actually
charged in Fiscal Year 1995; in subsequent | 19 | | years, the premium shall
never be lower than the premium | 20 | | charged in Fiscal Year 1995. | 21 | | For Fiscal Year
2003, the premium shall not exceed 110% | 22 | | of the premium actually charged in
Fiscal Year 2002. | 23 | | For Fiscal Year 2004, the premium shall not exceed 112% | 24 | | of
the premium actually charged in Fiscal Year 2003.
| 25 | | For Fiscal Year 2005, the premium shall not exceed a | 26 | | weighted average of 106.6% of
the premium actually charged |
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| 1 | | in Fiscal Year 2004.
| 2 | | For Fiscal Year 2006, the premium shall not exceed a | 3 | | weighted average of 109.1% of
the premium actually charged | 4 | | in Fiscal Year 2005.
| 5 | | For Fiscal Year 2007, the premium shall not exceed a | 6 | | weighted average of 103.9% of
the premium actually charged | 7 | | in Fiscal Year 2006.
| 8 | | For Fiscal Year 2008 through Fiscal Year 2013 and | 9 | | thereafter , the premium in each fiscal year shall not | 10 | | exceed 105% of
the premium actually charged in the previous | 11 | | fiscal year.
| 12 | | Rates and premiums shall may be based in part on age , and | 13 | | eligibility for federal
medicare coverage , years of service, | 14 | | pension income, and the type of insurance program selected . | 15 | | However, the cost of participation for a TRS dependent
| 16 | | beneficiary who is an unmarried child age 19 or over and | 17 | | mentally or physically
disabled shall not exceed the cost for a | 18 | | TRS dependent beneficiary who is
an unmarried child under age | 19 | | 19 and participates in the same major medical or
managed care | 20 | | program.
| 21 | | The cost of health benefits under the program shall be paid | 22 | | as follows:
| 23 | | (1) For each Medicare-covered a TRS benefit recipient | 24 | | selecting a managed care program , other than a | 25 | | Medicare-covered TRS benefit recipient who first becomes a | 26 | | teacher, as defined under paragraphs (1), (4), and (6) |
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| 1 | | through (10) of Section 16-106 of the Illinois Pension | 2 | | Code, on or after the effective date of this amendatory Act | 3 | | of the 97th General Assembly, up to 60%
75% of the total | 4 | | insurance rate shall be paid from the Teacher Health | 5 | | Insurance
Security Fund. Effective with Fiscal Year 2007 | 6 | | and thereafter, for a TRS benefit recipient selecting a | 7 | | managed care program, 75% of the total insurance rate shall | 8 | | be paid from the Teacher Health Insurance
Security Fund.
| 9 | | (2) For each non-Medicare-covered a TRS benefit | 10 | | recipient selecting the major medical coverage
program , | 11 | | other than a non-Medicare-covered TRS benefit recipient | 12 | | who either first becomes a TRS benefit recipient on or | 13 | | after the effective date of this amendatory Act of the 97th | 14 | | General Assembly or first becomes a teacher, as defined | 15 | | under paragraphs (1), (4), and (6) through (10) of Section | 16 | | 16-106 of the Illinois Pension Code, on or after the | 17 | | effective date of this amendatory Act of the 97th General | 18 | | Assembly, up to 60% 50% of the total insurance rate shall | 19 | | be paid from the Teacher
Health Insurance Security Fund if | 20 | | a managed care program is accessible, as
determined by the | 21 | | Teachers' Retirement System. Effective with Fiscal Year | 22 | | 2007 and thereafter, for a TRS benefit recipient selecting | 23 | | the major medical coverage
program, 50% of the total | 24 | | insurance rate shall be paid from the Teacher
Health | 25 | | Insurance Security Fund if a managed care program is | 26 | | accessible, as
determined by the Department of Central |
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| 1 | | Management Services .
| 2 | | (3) For each non-Medicare-covered a TRS benefit | 3 | | recipient who first becomes a TRS benefit recipient on or | 4 | | after the effective date of this amendatory Act of the 97th | 5 | | General Assembly, other than a non-Medicare-covered TRS | 6 | | benefit recipient who first becomes a teacher, as defined | 7 | | under paragraphs (1), (4), and (6) through (10) of Section | 8 | | 16-106 of the Illinois Pension Code, on or after the | 9 | | effective date of this amendatory Act of the 97th General | 10 | | Assembly selecting the major medical coverage
program , up | 11 | | to 60% 75% of the total insurance rate that would be paid | 12 | | on behalf of that TRS benefit recipient if he or she were | 13 | | eligible for Medicare shall be paid from the Teacher
Health | 14 | | Insurance Security Fund if a managed care program is not | 15 | | accessible, as
determined by the Teachers' Retirement | 16 | | System. Effective with Fiscal Year 2007 and thereafter, for | 17 | | a TRS benefit recipient selecting the major medical | 18 | | coverage
program, 75% of the total insurance rate shall be | 19 | | paid from the Teacher
Health Insurance Security Fund if a | 20 | | managed care program is not accessible, as
determined by | 21 | | the Department of Central Management Services .
| 22 | | (3.1) For each a TRS benefit recipient who first | 23 | | becomes a teacher, as defined under paragraphs (1), (4), | 24 | | and (6) through (10) of Section 16-106 of the Illinois | 25 | | Pension Code, on or after the effective date of this | 26 | | amendatory Act of the 97th General Assembly, no portion of |
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| 1 | | the total insurance rate shall be paid from the Teacher
| 2 | | Health Insurance Security Fund. dependent beneficiary who | 3 | | is Medicare primary and enrolled in a managed care plan, or | 4 | | the major medical coverage program if a managed care plan | 5 | | is not available, 25% of the total insurance rate shall be | 6 | | paid from the Teacher Health Security Fund as determined by | 7 | | the Department of Central Management Services. For the | 8 | | purpose of this item (3.1), the term "TRS dependent | 9 | | beneficiary who is Medicare primary" means a TRS dependent | 10 | | beneficiary who is participating in Medicare Parts A and B.
| 11 | | (4) The Except as otherwise provided in item (3.1), the
| 12 | | balance of the rate of insurance, including the entire | 13 | | premium of
any coverage for TRS dependent beneficiaries | 14 | | that has been elected, shall be
paid
by deductions | 15 | | authorized by the TRS benefit recipient to be withheld from | 16 | | his
or her monthly annuity or benefit payment from the | 17 | | Teachers' Retirement System;
except that (i) if the balance | 18 | | of the cost of coverage exceeds the amount of
the monthly | 19 | | annuity or benefit payment, the difference shall be paid | 20 | | directly
to the Teachers' Retirement System by the TRS | 21 | | benefit recipient, and (ii) all
or part of the balance of | 22 | | the cost of coverage may, at the school board's
option, be | 23 | | paid to the Teachers' Retirement System by the school board | 24 | | of the
school district from which the TRS benefit recipient | 25 | | retired, in accordance
with Section 10-22.3b of the School | 26 | | Code. The Teachers' Retirement System
shall promptly |
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| 1 | | deposit all moneys withheld by or paid to it under this
| 2 | | subdivision (e)(4) into the Teacher Health Insurance | 3 | | Security Fund. These
moneys shall not be considered assets | 4 | | of the Retirement System.
| 5 | | (f) Financing. Beginning July 1, 1995, all revenues arising | 6 | | from the
administration of the health benefit programs | 7 | | established under Article 16 of
the Illinois Pension Code or | 8 | | this Section shall be deposited into the
Teacher Health | 9 | | Insurance Security Fund, which is hereby created as a
| 10 | | nonappropriated trust fund to be held outside the State | 11 | | Treasury, with the
State Treasurer as custodian. Any interest | 12 | | earned on moneys in the Teacher
Health Insurance Security Fund | 13 | | shall be deposited into the Fund.
| 14 | | Moneys in the Teacher Health Insurance Security
Fund shall | 15 | | be used only to pay the costs of the health benefit program
| 16 | | established under this Section, including associated | 17 | | administrative costs, and
the costs associated with the health | 18 | | benefit program established under Article
16 of the Illinois | 19 | | Pension Code, as authorized in this Section. Beginning
July 1, | 20 | | 1995, the Department of Central Management Services may make
| 21 | | expenditures from the Teacher Health Insurance Security Fund | 22 | | for those costs.
| 23 | | After other funds authorized for the payment of the costs | 24 | | of the health
benefit program established under Article 16 of | 25 | | the Illinois Pension Code are
exhausted and until January 1, | 26 | | 1996 (or such later date as may be agreed upon
by the Director |
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| 1 | | of Central Management Services and the Secretary of the
| 2 | | Teachers' Retirement System), the Secretary of the Teachers' | 3 | | Retirement System
may make expenditures from the Teacher Health | 4 | | Insurance Security Fund as
necessary to pay up to 75% of the | 5 | | cost of providing health coverage to eligible
benefit | 6 | | recipients (as defined in Sections 16-153.1 and 16-153.3 of the
| 7 | | Illinois Pension Code) who are enrolled in the Article 16 | 8 | | health benefit
program and to facilitate the transfer of | 9 | | administration of the health benefit
program to the Department | 10 | | of Central Management Services.
| 11 | | The Department of Healthcare and Family Services, or any | 12 | | successor agency designated to procure healthcare contracts | 13 | | pursuant to this Act, is authorized to establish funds, | 14 | | separate accounts provided by any bank or banks as defined by | 15 | | the Illinois Banking Act, or separate accounts provided by any | 16 | | savings and loan association or associations as defined by the | 17 | | Illinois Savings and Loan Act of 1985 to be held by the | 18 | | Director, outside the State treasury, for the purpose of | 19 | | receiving the transfer of moneys from the Teacher Health | 20 | | Insurance Security Fund. The Department may promulgate rules | 21 | | further defining the methodology for the transfers. Any | 22 | | interest earned by moneys in the funds or accounts shall inure | 23 | | to the Teacher Health Insurance Security Fund. The transferred | 24 | | moneys, and interest accrued thereon, shall be used exclusively | 25 | | for transfers to administrative service organizations or their | 26 | | financial institutions for payments of claims to claimants and |
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| 1 | | providers under the self-insurance health plan. The | 2 | | transferred moneys, and interest accrued thereon, shall not be | 3 | | used for any other purpose including, but not limited to, | 4 | | reimbursement of administration fees due the administrative | 5 | | service organization pursuant to its contract or contracts with | 6 | | the Department.
| 7 | | (g) Contract for benefits. The Director shall by contract, | 8 | | self-insurance,
or otherwise make available the program of | 9 | | health benefits for TRS benefit
recipients and their TRS | 10 | | dependent beneficiaries that is provided for in this
Section. | 11 | | The contract or other arrangement for the provision of these | 12 | | health
benefits shall be on terms deemed by the Director to be | 13 | | in the best interest of
the State of Illinois and the TRS | 14 | | benefit recipients based on, but not limited
to, such criteria | 15 | | as administrative cost, service capabilities of the carrier
or | 16 | | other contractor, and the costs of the benefits.
| 17 | | (g-5) Committee. A Teacher Retirement Insurance Program | 18 | | Committee shall be established, to consist of 10 persons | 19 | | appointed by the Governor.
| 20 | | The Committee shall convene at least 4 times each year, and | 21 | | shall consider and make recommendations on issues affecting the | 22 | | program of health benefits provided under this
Section. | 23 | | Recommendations of the Committee shall be based on a consensus | 24 | | of the members of the Committee.
| 25 | | If the Teacher
Health Insurance Security Fund experiences a | 26 | | deficit balance based upon the contribution and subsidy rates |
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| 1 | | established in this Section and Section 6.6 for Fiscal Year | 2 | | 2008 or thereafter, the Committee shall make recommendations | 3 | | for adjustments to the funding sources established under these | 4 | | Sections. | 5 | | In addition, the Committee shall identify proposed | 6 | | solutions to the funding shortfalls that are affecting the | 7 | | Teacher Health Insurance Security Fund, and it shall report | 8 | | those solutions to the Governor and the General Assembly within | 9 | | 6 months after August 15, 2011 ( the effective date of Public | 10 | | Act 97-386) this amendatory Act of the 97th General Assembly . | 11 | | (h) Continuation of program. It is the intention of
the | 12 | | General Assembly that the program of health benefits provided | 13 | | under this
Section be maintained on an ongoing, affordable | 14 | | basis.
| 15 | | The program of health benefits provided under this Section | 16 | | may be amended by
the State and is not intended to be a pension | 17 | | or retirement benefit subject to
protection under Article XIII, | 18 | | Section 5 of the Illinois Constitution.
| 19 | | (i) Repeal. (Blank).
| 20 | | (Source: P.A. 96-1519, eff. 2-4-11; 97-386, eff. 8-15-11; | 21 | | revised 9-2-11.)
| 22 | | (5 ILCS 375/6.9)
| 23 | | Sec. 6.9. Health benefits for community college benefit | 24 | | recipients and
community college dependent beneficiaries.
| 25 | | (a) Purpose. It is the purpose of this amendatory Act of |
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| 1 | | 1997 to establish
a uniform program of health benefits for | 2 | | community college benefit recipients
and their dependent | 3 | | beneficiaries under the administration of the Department of
| 4 | | Central Management Services.
| 5 | | (b) Creation of program. Beginning July 1, 1999, the | 6 | | Department of
Central Management Services shall be responsible | 7 | | for administering a program of
health benefits for community | 8 | | college benefit recipients and community college
dependent | 9 | | beneficiaries under this Section. The State Universities | 10 | | Retirement
System and the boards of trustees of the various | 11 | | community college districts
shall cooperate with the | 12 | | Department in this endeavor.
| 13 | | (c) Eligibility. All community college benefit recipients | 14 | | and community
college dependent beneficiaries shall be | 15 | | eligible to participate in the program
established under this | 16 | | Section, without any interruption or delay in coverage
or | 17 | | limitation as to pre-existing medical conditions. Eligibility | 18 | | to
participate shall be determined by the State Universities | 19 | | Retirement System.
Eligibility information shall be | 20 | | communicated to the Department of Central
Management Services | 21 | | in a format acceptable to the Department.
| 22 | | (d) Coverage. The health benefit coverage provided under | 23 | | this Section
shall be a program of health, dental, and vision | 24 | | benefits.
| 25 | | The program of health benefits under this Section may | 26 | | include any or all of
the benefit limitations, including but |
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| 1 | | not limited to a reduction in benefits
based on eligibility for | 2 | | federal medicare benefits, that are provided under
subsection | 3 | | (a) of Section 6 of this Act for other health benefit programs | 4 | | under
this Act.
| 5 | | (e) Insurance rates and premiums. The Director shall | 6 | | determine the
insurance rates and premiums for community | 7 | | college benefit recipients and
community college dependent | 8 | | beneficiaries. Rates and premiums may be based
in part on age , | 9 | | and eligibility for federal Medicare coverage , years of | 10 | | service, pension income, and the type of insurance program | 11 | | selected .
The Director shall also determine premiums that will | 12 | | allow for the
establishment of an actuarially sound reserve for | 13 | | this program.
| 14 | | The cost of health benefits under the program shall be paid | 15 | | as follows:
| 16 | | (1) For each Medicare-covered a community college | 17 | | benefit recipient, other than a Medicare-covered community | 18 | | college benefit recipient who first becomes eligible, on or | 19 | | after the effective date of this amendatory Act of the 97th | 20 | | General Assembly, to participate in the program | 21 | | established under this Section, up to 60% 75% of the total
| 22 | | insurance rate shall be paid from the Community College | 23 | | Health Insurance
Security Fund.
| 24 | | (1.1) For each non-Medicare-covered community college | 25 | | benefit recipient, other than a non-Medicare-covered | 26 | | community college benefit recipient who either first |
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| 1 | | becomes a community college benefit recipient on or after | 2 | | the effective date of this amendatory Act of the 97th | 3 | | General Assembly or first becomes eligible, on or after the | 4 | | effective date of this amendatory Act of the 97th General | 5 | | Assembly, to participate in the program established under | 6 | | this Section, up to 60% of the total insurance rate shall | 7 | | be paid from the Community College Health Insurance
| 8 | | Security Fund. | 9 | | (1.2) For each non-Medicare-covered community college | 10 | | benefit recipient who first becomes a community college | 11 | | benefit recipient on or after the effective date of this | 12 | | amendatory Act of the 97th General Assembly, other than a | 13 | | non-Medicare-covered community college benefit recipient | 14 | | who first becomes eligible, on or after the effective date | 15 | | of this amendatory Act of the 97th General Assembly, to | 16 | | participate in the program established under this Section, | 17 | | up to 60% of the total insurance rate that would be paid on | 18 | | behalf of the community college benefit recipient if he or | 19 | | she were eligible for Medicare shall be paid from the | 20 | | Community College Health Insurance
Security Fund. | 21 | | (1.3) For each community college benefit recipient who | 22 | | first becomes eligible, on or after the effective date of | 23 | | this amendatory Act of the 97th General Assembly, to | 24 | | participate in the program established under this Section, | 25 | | no portion of the total insurance rate shall be paid from | 26 | | the Community College Health Insurance
Security Fund.
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| 1 | | (2) The balance of the rate of insurance, including the | 2 | | entire premium
for any coverage for community college | 3 | | dependent beneficiaries that has been
elected, shall be | 4 | | paid by deductions authorized by the community college
| 5 | | benefit recipient to be withheld from his or her monthly | 6 | | annuity or benefit
payment from the State Universities | 7 | | Retirement System; except that (i) if the
balance of the | 8 | | cost of coverage exceeds the amount of the monthly annuity | 9 | | or
benefit payment, the difference shall be paid directly | 10 | | to the State
Universities Retirement System by the | 11 | | community college benefit recipient, and
(ii) all or part | 12 | | of the balance of the cost of coverage may, at the option | 13 | | of
the board of trustees of the community college district, | 14 | | be paid to
the State Universities Retirement System by the | 15 | | board of the community college
district from which the | 16 | | community college benefit recipient retired. The State
| 17 | | Universities Retirement System shall promptly deposit all | 18 | | moneys withheld by or
paid to it under this subdivision | 19 | | (e)(2) into the Community College Health
Insurance | 20 | | Security Fund. These moneys shall not be considered assets | 21 | | of the
State Universities Retirement System.
| 22 | | (f) Financing. All revenues arising from the | 23 | | administration of the health
benefit program established under | 24 | | this Section shall be deposited into the
Community College | 25 | | Health Insurance Security Fund, which is hereby created as a
| 26 | | nonappropriated trust fund to be held outside the State |
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| 1 | | Treasury, with the
State Treasurer as custodian. Any interest | 2 | | earned on moneys in the Community
College Health Insurance | 3 | | Security Fund shall be deposited into the Fund.
| 4 | | Moneys in the Community College Health Insurance Security | 5 | | Fund shall be used
only to pay the costs of the health benefit | 6 | | program established under this
Section, including associated | 7 | | administrative costs and the establishment of a
program | 8 | | reserve. Beginning January 1, 1999,
the Department of Central | 9 | | Management Services may make expenditures from the
Community | 10 | | College Health Insurance Security Fund for those costs.
| 11 | | (g) Contract for benefits. The Director shall by contract, | 12 | | self-insurance,
or otherwise make available the program of | 13 | | health benefits for community
college benefit recipients and | 14 | | their community college dependent beneficiaries
that is | 15 | | provided for in this Section. The contract or other arrangement | 16 | | for
the provision of these health benefits shall be on terms | 17 | | deemed by the Director
to be in the best interest of the State | 18 | | of Illinois and the community college
benefit recipients based | 19 | | on, but not limited to, such criteria as
administrative cost, | 20 | | service capabilities of the carrier or other contractor,
and | 21 | | the costs of the benefits.
| 22 | | (h) Continuation of program. It is the intention of the | 23 | | General Assembly
that the program of health benefits provided | 24 | | under this Section be maintained
on an ongoing, affordable | 25 | | basis. The program of health benefits provided under
this | 26 | | Section may be amended by the State and is not intended to be a |
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| 1 | | pension or
retirement benefit subject to protection under | 2 | | Article XIII, Section 5 of the
Illinois Constitution.
| 3 | | (i) Other health benefit plans. A health benefit plan | 4 | | provided by a
community college district (other than a | 5 | | community college district subject to
Article VII of the Public | 6 | | Community College Act) under the terms of a
collective | 7 | | bargaining agreement in effect on or prior to the effective | 8 | | date of
this amendatory Act of 1997 shall continue in force | 9 | | according to the terms of
that agreement, unless otherwise | 10 | | mutually agreed by the parties to that
agreement and the | 11 | | affected retiree.
A community college benefit recipient or | 12 | | community college dependent
beneficiary whose coverage under | 13 | | such a plan expires shall be eligible to begin
participating in | 14 | | the program established under this Section without any
| 15 | | interruption or delay in coverage or limitation as to | 16 | | pre-existing medical
conditions.
| 17 | | This Act does not prohibit any community college district | 18 | | from offering
additional health benefits for its retirees or | 19 | | their dependents or survivors.
| 20 | | (Source: P.A. 90-497, eff. 8-18-97; 90-655, eff. 7-30-98.)
| 21 | | (5 ILCS 375/10) (from Ch. 127, par. 530)
| 22 | | Sec. 10. Payments by State; premiums.
| 23 | | (a) Except as otherwise provided in this Section, the The | 24 | | State shall pay the cost of basic non-contributory group life
| 25 | | insurance and, subject to member paid contributions set by the |
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| 1 | | Department or
required by this Section, the basic program of | 2 | | group health benefits on each
eligible member, except a member, | 3 | | not otherwise
covered by this Act, who has retired as a | 4 | | participating member under Article 2
of the Illinois Pension | 5 | | Code but is ineligible for the retirement annuity under
Section | 6 | | 2-119 of the Illinois Pension Code, and part of each eligible | 7 | | member's
and retired member's premiums for health insurance | 8 | | coverage for enrolled
dependents as provided by Section 9. The | 9 | | State shall pay the cost of the basic
program of group health | 10 | | benefits only after benefits are reduced by the amount
of | 11 | | benefits covered by Medicare for all members and dependents
who | 12 | | are eligible for benefits under Social Security or
the Railroad | 13 | | Retirement system or who had sufficient Medicare-covered
| 14 | | government employment, except that such reduction in benefits | 15 | | shall apply only
to those members and dependents who (1) first | 16 | | become eligible
for such Medicare coverage on or after July 1, | 17 | | 1992; or (2) are
Medicare-eligible members or dependents of a | 18 | | local government unit which began
participation in the program | 19 | | on or after July 1, 1992; or (3) remain eligible
for, but no | 20 | | longer receive Medicare coverage which they had been receiving | 21 | | on
or after July 1, 1992. The Department may determine the | 22 | | aggregate level of the
State's contribution on the basis of | 23 | | actual cost of medical services adjusted
for age, sex or | 24 | | geographic or other demographic characteristics which affect
| 25 | | the costs of such programs.
| 26 | | The cost of participation in the basic program of group |
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| 1 | | health benefits
for the dependent or survivor of a living or | 2 | | deceased retired employee who was
formerly employed by the | 3 | | University of Illinois in the Cooperative Extension
Service and | 4 | | would be an annuitant but for the fact that he or she was made
| 5 | | ineligible to participate in the State Universities Retirement | 6 | | System by clause
(4) of subsection (a) of Section 15-107 of the | 7 | | Illinois Pension Code shall not
be greater than the cost of | 8 | | participation that would otherwise apply to that
dependent or | 9 | | survivor if he or she were the dependent or survivor of an
| 10 | | annuitant under the State Universities Retirement System.
| 11 | | (a-1) (Blank). Beginning January 1, 1998, for each person | 12 | | who becomes a new SERS
annuitant and participates in the basic | 13 | | program of group health benefits, the
State shall contribute | 14 | | toward the cost of the annuitant's
coverage under the basic | 15 | | program of group health benefits an amount equal
to 5% of that | 16 | | cost for each full year of creditable service upon which the
| 17 | | annuitant's retirement annuity is based, up to a maximum of | 18 | | 100% for an
annuitant with 20 or more years of creditable | 19 | | service.
The remainder of the cost of a new SERS annuitant's | 20 | | coverage under the basic
program of group health benefits shall | 21 | | be the responsibility of the
annuitant. In the case of a new | 22 | | SERS annuitant who has elected to receive an alternative | 23 | | retirement cancellation payment under Section 14-108.5 of the | 24 | | Illinois Pension Code in lieu of an annuity, for the purposes | 25 | | of this subsection the annuitant shall be deemed to be | 26 | | receiving a retirement annuity based on the number of years of |
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| 1 | | creditable service that the annuitant had established at the | 2 | | time of his or her termination of service under SERS.
| 3 | | (a-2) (Blank). Beginning January 1, 1998, for each person | 4 | | who becomes a new SERS
survivor and participates in the basic | 5 | | program of group health benefits, the
State shall contribute | 6 | | toward the cost of the survivor's
coverage under the basic | 7 | | program of group health benefits an amount equal
to 5% of that | 8 | | cost for each full year of the deceased employee's or deceased
| 9 | | annuitant's creditable service in the State Employees' | 10 | | Retirement System of
Illinois on the date of death, up to a | 11 | | maximum of 100% for a survivor of an
employee or annuitant with | 12 | | 20 or more years of creditable service. The
remainder of the | 13 | | cost of the new SERS survivor's coverage under the basic
| 14 | | program of group health benefits shall be the responsibility of | 15 | | the survivor. In the case of a new SERS survivor who was the | 16 | | dependent of an annuitant who elected to receive an alternative | 17 | | retirement cancellation payment under Section 14-108.5 of the | 18 | | Illinois Pension Code in lieu of an annuity, for the purposes | 19 | | of this subsection the deceased annuitant's creditable service | 20 | | shall be determined as of the date of termination of service | 21 | | rather than the date of death.
| 22 | | (a-3) (Blank). Beginning January 1, 1998, for each person | 23 | | who becomes a new SURS
annuitant and participates in the basic | 24 | | program of group health benefits, the
State shall contribute | 25 | | toward the cost of the annuitant'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 creditable service upon which the
| 2 | | annuitant's retirement annuity is based, up to a maximum of | 3 | | 100% for an
annuitant with 20 or more years of creditable | 4 | | service.
The remainder of the cost of a new SURS annuitant's | 5 | | coverage under the basic
program of group health benefits shall | 6 | | be the responsibility of the
annuitant.
| 7 | | (a-4) (Blank).
| 8 | | (a-5) (Blank). Beginning January 1, 1998, for each person | 9 | | who becomes a new SURS
survivor and participates in the basic | 10 | | program of group health benefits, the
State shall contribute | 11 | | toward the cost of the survivor's coverage under the
basic | 12 | | program of group health benefits an amount equal to 5% of that | 13 | | cost for
each full year of the deceased employee's or deceased | 14 | | annuitant's creditable
service in the State Universities | 15 | | Retirement System on the date of death, up to
a maximum of 100% | 16 | | for a survivor of an
employee or annuitant with 20 or more | 17 | | years of creditable service. The
remainder of the cost of the | 18 | | new SURS survivor's coverage under the basic
program of group | 19 | | health benefits shall be the responsibility of the survivor.
| 20 | | (a-6) (Blank). Beginning July 1, 1998, for each person who | 21 | | becomes a new TRS
State annuitant and participates in the basic | 22 | | program of group health benefits,
the State shall contribute | 23 | | toward the cost of the annuitant's coverage under
the basic | 24 | | program of group health benefits an amount equal to 5% of that | 25 | | cost
for each full year of creditable service
as a teacher as | 26 | | defined in paragraph (2), (3), or (5) of Section 16-106 of the
|
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| 1 | | Illinois Pension Code
upon which the annuitant's retirement | 2 | | annuity is based, up to a maximum of
100%;
except that
the | 3 | | State contribution shall be 12.5% per year (rather than 5%) for | 4 | | each full
year of creditable service as a regional | 5 | | superintendent or assistant regional
superintendent of | 6 | | schools. The
remainder of the cost of a new TRS State | 7 | | annuitant's coverage under the basic
program of group health | 8 | | benefits shall be the responsibility of the
annuitant.
| 9 | | (a-7) (Blank). Beginning July 1, 1998, for each person who | 10 | | becomes a new TRS
State survivor and participates in the basic | 11 | | program of group health benefits,
the State shall contribute | 12 | | toward the cost of the survivor's coverage under the
basic | 13 | | program of group health benefits an amount equal to 5% of that | 14 | | cost for
each full year of the deceased employee's or deceased | 15 | | annuitant's creditable
service
as a teacher as defined in | 16 | | paragraph (2), (3), or (5) of Section 16-106 of the
Illinois | 17 | | Pension Code
on the date of death, up to a maximum of 100%;
| 18 | | except that the State contribution shall be 12.5% per year | 19 | | (rather than 5%) for
each full year of the deceased employee's | 20 | | or deceased annuitant's creditable
service as a regional | 21 | | superintendent or assistant regional superintendent of
| 22 | | schools.
The remainder of
the cost of the new TRS State | 23 | | survivor's coverage under the basic program of
group health | 24 | | benefits shall be the responsibility of the survivor.
| 25 | | (a-8) Any A new SERS annuitant, new SERS survivor , or | 26 | | retired employee , new SURS
annuitant, new SURS survivor, new |
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| 1 | | TRS State
annuitant, or new TRS State survivor may waive or | 2 | | terminate coverage in
the program of group health benefits. Any | 3 | | such annuitant , or survivor , or retired employee
who has waived | 4 | | or terminated coverage may enroll or re-enroll in the
program | 5 | | of group health benefits only during the annual benefit choice | 6 | | period,
as determined by the Director; except that in the event | 7 | | of termination of
coverage due to nonpayment of premiums, the | 8 | | annuitant , or survivor , or retired employee
may not re-enroll | 9 | | in the program.
| 10 | | (a-8.5) Beginning on the effective date of this amendatory | 11 | | Act of the 97th General Assembly, the Director of Central | 12 | | Management Services shall annually determine the amount that | 13 | | each annuitant, survivor, and retired employee shall | 14 | | contribute toward the basic program of group health benefits. | 15 | | To determine that amount, the Director shall take into account | 16 | | benefit points (which are calculated by summing (i) in the case | 17 | | of annuitants and retired employees, the age in years of the | 18 | | benefit recipient when his or her benefits commence and, in the | 19 | | case of survivors, the age in years of the decedent at the time | 20 | | of death and (ii) the total years of service of the person upon | 21 | | whose service that benefit is based) and annual pension income | 22 | | in accordance with the requirements of this Act and the | 23 | | schedule of required contributions set forth in paragraphs (1) | 24 | | through (5) of this subsection (a-8.5): | 25 | | (1) For an annuitant, survivor, or retired employee | 26 | | with fewer than 63 benefit points, the required |
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| 1 | | contribution shall be 100% of the cost of coverage, | 2 | | regardless of pension income. | 3 | | (2) For an annuitant, survivor, or retired employee | 4 | | with 63 to 78 benefit points and: | 5 | | (A) an annual pension income of less than $15,000, | 6 | | the required contribution shall be 20% of the cost of | 7 | | coverage. | 8 | | (B) an annual pension income of at least $15,000 | 9 | | but less than $30,000, the required contribution shall | 10 | | be 40% of the cost of coverage. | 11 | | (C) an annual pension income of at least $30,000 | 12 | | but less than $50,000, the required contribution shall | 13 | | be 60% of the cost of coverage. | 14 | | (D) an annual pension income of at least $50,000 | 15 | | but less than $100,000, the required contribution | 16 | | shall be 80% of the cost of coverage. | 17 | | (E) an annual pension income of at least $100,000 | 18 | | but less than $125,000, the required contribution | 19 | | shall be 100% of the cost of coverage. | 20 | | (F) an annual pension income of $125,000 or more, | 21 | | the required contribution shall be 100% of the | 22 | | applicable premium. | 23 | | (3) For an annuitant, survivor, or retired employee | 24 | | with 79 to 85 benefit points and: | 25 | | (A) an annual pension income of less than $15,000, | 26 | | the required contribution shall be 15% of the cost of |
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| 1 | | coverage. | 2 | | (B) an annual pension income of at least $15,000 | 3 | | but less than $30,000, the required contribution shall | 4 | | be 30% of the cost of coverage. | 5 | | (C) an annual pension income of at least $30,000 | 6 | | but less than $50,000, the required contribution shall | 7 | | be 50% of the cost of coverage. | 8 | | (D) an annual pension income of at least $50,000 | 9 | | but less than $100,000, the required contribution | 10 | | shall be 65% of the cost of coverage. | 11 | | (E) an annual pension income of at least $100,000 | 12 | | but less than $125,000, the required contribution | 13 | | shall be 85% of the cost of coverage. | 14 | | (F) an annual pension income of $125,000 or more, | 15 | | the required contribution shall be 95% of the cost of | 16 | | coverage. | 17 | | (4) For an annuitant, survivor, or retired employee | 18 | | with 86 to 92 benefit points and: | 19 | | (A) an annual pension income of less than $15,000, | 20 | | the required contribution shall be 10% of the cost of | 21 | | coverage. | 22 | | (B) an annual pension income of at least $15,000 | 23 | | but less than $30,000, the required contribution shall | 24 | | be 20% of the cost of coverage. | 25 | | (C) an annual pension income of at least $30,000 | 26 | | but less than $50,000, the required contribution shall |
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| 1 | | be 35% of the cost of coverage. | 2 | | (D) an annual pension income of at least $50,000 | 3 | | but less than $100,000, the required contribution | 4 | | shall be 50% of the cost of coverage. | 5 | | (E) an annual pension income of at least $100,000 | 6 | | but less than $125,000, the required contribution | 7 | | shall be 70% of the cost of coverage. | 8 | | (F) an annual pension income of $125,000 or more, | 9 | | the required contribution shall be 90% of the cost of | 10 | | coverage. | 11 | | (5) For an annuitant, survivor, or retired employee | 12 | | with 93 or more benefit points and: | 13 | | (A) an annual pension income of less than $15,000, | 14 | | the required contribution shall be 5% of the cost of | 15 | | coverage. | 16 | | (B) an annual pension income of at least $15,000 | 17 | | but less than $30,000, the required contribution shall | 18 | | be 10% of the cost of coverage. | 19 | | (C) an annual pension income of at least $30,000 | 20 | | but less than $50,000, the required contribution shall | 21 | | be 25% of the cost of coverage. | 22 | | (D) an annual pension income of at least $50,000 | 23 | | but less than $100,000, the required contribution | 24 | | shall be 35% of the cost of coverage. | 25 | | (E) an annual pension income of at least $100,000 | 26 | | but less than $125,000, the required contribution |
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| 1 | | shall be 60% of the cost of coverage. | 2 | | (F) an annual pension income of $125,000 or more, | 3 | | the required contribution shall be 80% of the cost of | 4 | | coverage. | 5 | | The Director may by administrative rule alter the schedule | 6 | | of required contributions set forth in paragraphs (1) through | 7 | | (5) of this subsection to ensure (i) that at least 40% of the | 8 | | costs associated with the basic program of group health | 9 | | benefits for retired employees are covered by retired | 10 | | employees, at least 40% of the costs associated with the basic | 11 | | program of group health benefits for annuitants are covered by | 12 | | annuitants, and at least 40% of the costs associated with the | 13 | | basic program of group health benefits for survivors are | 14 | | covered by survivors and (ii) that any costs that are | 15 | | associated with the basic program of group health benefits and | 16 | | not covered either by the State under subsection (a-8.6) or by | 17 | | the annuitant, survivor, or retired employee under paragraphs | 18 | | (1) through (5) of this subsection are covered by the | 19 | | annuitant, survivor, or retired employee, as applicable. | 20 | | (a-8.6) Beginning on the effective date of this amendatory | 21 | | Act of the 97th General Assembly, the State shall contribute | 22 | | toward the basic program of group health benefits the following | 23 | | amounts: | 24 | | (1) for each Medicare-covered annuitant, | 25 | | Medicare-covered survivor, and Medicare-covered retired | 26 | | employee, other than a Medicare-covered annuitant, |
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| 1 | | Medicare-covered survivor, or Medicare-covered retired | 2 | | employee who first becomes an employee on or after the | 3 | | effective date of this amendatory Act of the 97th General | 4 | | Assembly, the remainder of
the cost of coverage under the | 5 | | basic program of
group health benefits; and | 6 | | (2) for each non-Medicare-covered annuitant, | 7 | | non-Medicare-covered survivor, and non-Medicare-covered | 8 | | retired employee, other than a non-Medicare-covered | 9 | | annuitant, non-Medicare-covered survivor, and | 10 | | non-Medicare-covered retired employee who either first | 11 | | becomes an annuitant, survivor, or retired employee on or | 12 | | after the effective date of this amendatory Act of the 97th | 13 | | General Assembly or first becomes an employee on or after | 14 | | the effective date of this amendatory Act of the 97th | 15 | | General Assembly, the remainder of
the cost of coverage | 16 | | under the basic program of
group health benefits; and | 17 | | (3) for each non-Medicare-covered annuitant, | 18 | | non-Medicare-covered survivor, and non-Medicare-covered | 19 | | retired employee who first becomes an annuitant, survivor, | 20 | | or retired employee on or after the effective date of this | 21 | | amendatory Act of the 97th General Assembly, other than a | 22 | | non-Medicare-covered annuitant, non-Medicare-covered | 23 | | survivor, or non-Medicare-covered retired employee who | 24 | | first becomes an employee on or after the effective date of | 25 | | this amendatory Act of the 97th General Assembly, an amount | 26 | | that is equal to the amount that the State would pay for |
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| 1 | | that annuitant, survivor, or retired employee if he or she | 2 | | were covered by Medicare. | 3 | | Regardless of Medicare coverage, the State shall not | 4 | | contribute toward the basic program of group health benefits | 5 | | for annuitants, survivors, or retired employees who first | 6 | | become employees on or after the effective date of this | 7 | | amendatory Act of the 97th General Assembly. In addition, the | 8 | | State's contribution for out-of-State residents shall not | 9 | | exceed its contribution for in-State residents. | 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 Healthcare and Family 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 | | (b) State employees who become eligible for this program on | 21 | | or after January
1, 1980 in positions normally requiring actual | 22 | | performance of duty not less
than 1/2 of a normal work period | 23 | | but not equal to that of a normal work period,
shall be given | 24 | | the option of participating in the available program. If the
| 25 | | employee elects coverage, the State shall contribute on behalf | 26 | | of such employee
to the cost of the employee's benefit and any |
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| 1 | | applicable dependent supplement,
that sum which bears the same | 2 | | percentage as that percentage of time the
employee regularly | 3 | | works when compared to normal work period.
| 4 | | (c) The basic non-contributory coverage from the basic | 5 | | program of
group health benefits shall be continued for each | 6 | | employee not in pay status or
on active service by reason of | 7 | | (1) leave of absence due to illness or injury,
(2) authorized | 8 | | educational leave of absence or sabbatical leave, or (3)
| 9 | | military leave. This coverage shall continue until
expiration | 10 | | of authorized leave and return to active service, but not to | 11 | | exceed
24 months for leaves under item (1) or (2). This | 12 | | 24-month limitation and the
requirement of returning to active | 13 | | service shall not apply to persons receiving
ordinary or | 14 | | accidental disability benefits or retirement benefits through | 15 | | the
appropriate State retirement system or benefits under the | 16 | | Workers' Compensation
or Occupational Disease Act.
| 17 | | (d) The basic group life insurance coverage shall continue, | 18 | | with
full State contribution, where such person is (1) absent | 19 | | from active
service by reason of disability arising from any | 20 | | cause other than
self-inflicted, (2) on authorized educational | 21 | | leave of absence or
sabbatical leave, or (3) on military leave.
| 22 | | (e) Where the person is in non-pay status for a period in | 23 | | excess of
30 days or on leave of absence, other than by reason | 24 | | of disability,
educational or sabbatical leave, or military | 25 | | leave, such
person may continue coverage only by making | 26 | | personal
payment equal to the amount normally contributed by |
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| 1 | | the State on such person's
behalf. Such payments and coverage | 2 | | may be continued: (1) until such time as
the person returns to | 3 | | a status eligible for coverage at State expense, but not
to | 4 | | exceed 24 months or (2) until such person's employment or | 5 | | annuitant status
with the State is terminated (exclusive of any | 6 | | additional service imposed pursuant to law).
| 7 | | (f) The Department shall establish by rule the extent to | 8 | | which other
employee benefits will continue for persons in | 9 | | non-pay status or who are
not in active service.
| 10 | | (g) The State shall not pay the cost of the basic | 11 | | non-contributory
group life insurance, program of health | 12 | | benefits and other employee benefits
for members who are | 13 | | survivors as defined by paragraphs (1) and (2) of
subsection | 14 | | (q) of Section 3 of this Act. The costs of benefits for these
| 15 | | survivors shall be paid by the survivors or by the University | 16 | | of Illinois
Cooperative Extension Service, or any combination | 17 | | thereof.
However, the State shall pay the amount of the | 18 | | reduction in the cost of
participation, if any, resulting from | 19 | | the amendment to subsection (a) made
by this amendatory Act of | 20 | | the 91st General Assembly.
| 21 | | (h) Those persons occupying positions with any department | 22 | | as a result
of emergency appointments pursuant to Section 8b.8 | 23 | | of the Personnel Code
who are not considered employees under | 24 | | this Act shall be given the option
of participating in the | 25 | | programs of group life insurance, health benefits and
other | 26 | | employee benefits. Such persons electing coverage may |
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| 1 | | participate only
by making payment equal to the amount normally | 2 | | contributed by the State for
similarly situated employees. Such | 3 | | amounts shall be determined by the
Director. Such payments and | 4 | | coverage may be continued until such time as the
person becomes | 5 | | an employee pursuant to this Act or such person's appointment | 6 | | is
terminated.
| 7 | | (i) Any unit of local government within the State of | 8 | | Illinois
may apply to the Director to have its employees, | 9 | | annuitants, and their
dependents provided group health | 10 | | coverage under this Act on a non-insured
basis. To participate, | 11 | | a unit of local government must agree to enroll
all of its | 12 | | employees, who may select coverage under either the State group
| 13 | | health benefits plan or a health maintenance organization that | 14 | | has
contracted with the State to be available as a health care | 15 | | provider for
employees as defined in this Act. A unit of local | 16 | | government must remit the
entire cost of providing coverage | 17 | | under the State group health benefits plan
or, for coverage | 18 | | under a health maintenance organization, an amount determined
| 19 | | by the Director based on an analysis of the sex, age, | 20 | | geographic location, or
other relevant demographic variables | 21 | | for its employees, except that the unit of
local government | 22 | | shall not be required to enroll those of its employees who are
| 23 | | covered spouses or dependents under this plan or another group | 24 | | policy or plan
providing health benefits as long as (1) an | 25 | | appropriate official from the unit
of local government attests | 26 | | 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 unit of | 3 | | local government remits
the entire cost of providing coverage | 4 | | to those employees, except that a
participating school district | 5 | | must have enrolled at least 50% of its full-time
employees who | 6 | | have not waived coverage under the district's group health
plan | 7 | | by participating in a component of the district's cafeteria | 8 | | plan. A
participating school district is not required to enroll | 9 | | a full-time employee
who has waived coverage under the | 10 | | district's health plan, provided that an
appropriate official | 11 | | from the participating school district attests that the
| 12 | | full-time employee has waived coverage by participating in a | 13 | | component of the
district's cafeteria plan. For the purposes of | 14 | | this subsection, "participating
school district" includes a | 15 | | unit of local government whose primary purpose is
education as | 16 | | defined by the Department's rules.
| 17 | | Employees of a participating unit of local government who | 18 | | are not enrolled
due to coverage under another group health | 19 | | policy or plan may enroll in
the event of a qualifying change | 20 | | in status, special enrollment, special
circumstance as defined | 21 | | by the Director, or during the annual Benefit Choice
Period. A | 22 | | participating unit of local government may also elect to cover | 23 | | its
annuitants. Dependent coverage shall be offered on an | 24 | | optional basis, with the
costs paid by the unit of local | 25 | | government, its employees, or some combination
of the two as | 26 | | determined by the unit of local government. The unit of local
|
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| 1 | | government shall be responsible for timely collection and | 2 | | transmission of
dependent premiums.
| 3 | | The Director shall annually determine monthly rates of | 4 | | payment, 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, or
contributed | 9 | | by the State for basic insurance coverages on behalf of its
| 10 | | employees, adjusted for differences between State | 11 | | employees and employees
of the local government in age, | 12 | | sex, geographic location or other relevant
demographic | 13 | | variables, plus an amount sufficient to pay for the | 14 | | additional
administrative costs of providing coverage to | 15 | | employees of the unit of
local government and their | 16 | | dependents.
| 17 | | (2) In subsequent years, a further adjustment shall be | 18 | | made to reflect
the actual prior years' claims experience | 19 | | of the employees of the unit of
local government.
| 20 | | In the case of coverage of local government employees under | 21 | | a health
maintenance organization, the Director shall annually | 22 | | determine for each
participating unit of local government the | 23 | | maximum monthly amount the unit
may contribute toward that | 24 | | coverage, based on an analysis of (i) the age,
sex, geographic | 25 | | location, and other relevant demographic variables of the
| 26 | | unit's employees and (ii) the cost to cover those employees |
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| 1 | | under the State
group health benefits plan. The Director may | 2 | | similarly determine the
maximum monthly amount each unit of | 3 | | local government may contribute toward
coverage of its | 4 | | employees' dependents under a health maintenance organization.
| 5 | | Monthly payments by the unit of local government or its | 6 | | employees for
group health benefits plan or health maintenance | 7 | | organization coverage shall
be deposited in the Local | 8 | | Government Health Insurance Reserve Fund.
| 9 | | The Local Government Health Insurance Reserve Fund is | 10 | | hereby created as a nonappropriated trust fund to be held | 11 | | outside the State Treasury, with the State Treasurer as | 12 | | custodian. The Local Government Health Insurance Reserve Fund | 13 | | shall be a continuing
fund not subject to fiscal year | 14 | | limitations. The Local Government Health Insurance Reserve | 15 | | Fund is not subject to administrative charges or charge-backs, | 16 | | including but not limited to those authorized under Section 8h | 17 | | of the State Finance Act. All revenues arising from the | 18 | | administration of the health benefits program established | 19 | | under this Section shall be deposited into the Local Government | 20 | | Health Insurance Reserve Fund. Any interest earned on moneys in | 21 | | the Local Government Health Insurance Reserve Fund shall be | 22 | | deposited into the Fund. All expenditures from this Fund
shall | 23 | | be used for payments for health care benefits for local | 24 | | government and rehabilitation facility
employees, annuitants, | 25 | | and dependents, and to reimburse the Department or
its | 26 | | administrative service organization for all expenses incurred |
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| 1 | | in the
administration of benefits. No other State funds may be | 2 | | used for these
purposes.
| 3 | | A local government employer's participation or desire to | 4 | | participate
in a program created under this subsection shall | 5 | | not limit that employer's
duty to bargain with the | 6 | | representative of any collective bargaining unit
of its | 7 | | employees.
| 8 | | (j) Any rehabilitation facility within the State of | 9 | | Illinois may apply
to the Director to have its employees, | 10 | | annuitants, and their eligible
dependents provided group | 11 | | health coverage under this Act on a non-insured
basis. To | 12 | | participate, a rehabilitation facility must agree to enroll all
| 13 | | of its employees and remit the entire cost of providing such | 14 | | coverage for
its employees, except that the rehabilitation | 15 | | facility shall not be
required to enroll those of its employees | 16 | | who are covered spouses or
dependents under this plan or | 17 | | another group policy or plan providing health
benefits as long | 18 | | as (1) an appropriate official from the rehabilitation
facility | 19 | | attests that each employee not enrolled is a covered spouse or
| 20 | | dependent under this plan or another group policy or plan, and | 21 | | (2) at least
50% of the employees are enrolled and the | 22 | | rehabilitation facility remits
the entire cost of providing | 23 | | coverage to those employees. Employees of a
participating | 24 | | rehabilitation facility who are not enrolled due to coverage
| 25 | | under another group health policy or plan may enroll
in the | 26 | | event of a qualifying change in status, special enrollment, |
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| 1 | | special
circumstance as defined by the Director, or during the | 2 | | annual Benefit Choice
Period. A participating rehabilitation | 3 | | facility may also elect
to cover its annuitants. Dependent | 4 | | coverage shall be offered on an optional
basis, with the costs | 5 | | paid by the rehabilitation facility, its employees, or
some | 6 | | combination of the 2 as determined by the rehabilitation | 7 | | facility. The
rehabilitation facility shall be responsible for | 8 | | timely collection and
transmission of dependent premiums.
| 9 | | The Director shall annually determine quarterly rates of | 10 | | payment, subject
to the following constraints:
| 11 | | (1) In the first year of coverage, the rates shall be | 12 | | equal to the amount
normally charged to State employees for | 13 | | elected optional coverages or for
enrolled dependents | 14 | | coverages or other contributory coverages on behalf of
its | 15 | | employees, adjusted for differences between State | 16 | | employees and
employees of the rehabilitation facility in | 17 | | age, sex, geographic location
or other relevant | 18 | | demographic variables, plus an amount sufficient to pay
for | 19 | | the additional administrative costs of providing coverage | 20 | | to employees
of the rehabilitation facility and their | 21 | | dependents.
| 22 | | (2) In subsequent years, a further adjustment shall be | 23 | | made to reflect
the actual prior years' claims experience | 24 | | of the employees of the
rehabilitation facility.
| 25 | | Monthly payments by the rehabilitation facility or its | 26 | | employees for
group health benefits shall be deposited in the |
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| 1 | | Local Government Health
Insurance Reserve Fund.
| 2 | | (k) Any domestic violence shelter or service within the | 3 | | State of Illinois
may apply to the Director to have its | 4 | | employees, annuitants, and their
dependents provided group | 5 | | health coverage under this Act on a non-insured
basis. To | 6 | | participate, a domestic violence shelter or service must agree | 7 | | to
enroll all of its employees and pay the entire cost of | 8 | | providing such coverage
for its employees. The domestic | 9 | | violence shelter 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 domestic violence | 13 | | shelter 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 | | domestic violence shelter remits the entire cost of providing | 17 | | coverage to those employees. Employees of a participating | 18 | | domestic violence shelter who are not enrolled due to coverage | 19 | | under another group health policy or plan may enroll in the | 20 | | event of a qualifying change in status, special enrollment, or | 21 | | special circumstance as defined by the Director or during the | 22 | | annual Benefit Choice Period. A participating domestic | 23 | | violence shelter may also elect
to cover its annuitants. | 24 | | Dependent coverage shall be offered on an optional
basis, with
| 25 | | employees, or some combination of the 2 as determined by the | 26 | | domestic violence
shelter or service. The domestic violence |
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| 1 | | shelter or service shall be
responsible for timely collection | 2 | | and 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 domestic violence shelter or | 11 | | service in 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 domestic violence shelter or service | 15 | | and their 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 domestic
violence shelter or | 19 | | service.
| 20 | | Monthly payments by the domestic violence shelter or | 21 | | service or its employees
for group health insurance shall be | 22 | | deposited in the Local Government Health
Insurance Reserve | 23 | | Fund.
| 24 | | (l) A public community college or entity organized pursuant | 25 | | to the
Public Community College Act may apply to the Director | 26 | | initially to have
only annuitants not covered prior to July 1, |
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| 1 | | 1992 by the district's health
plan provided health coverage | 2 | | under this Act on a non-insured basis. The
community college | 3 | | must execute a 2-year contract to participate in the
Local | 4 | | Government Health Plan.
Any annuitant may enroll in the event | 5 | | of a qualifying change in status, special
enrollment, special | 6 | | circumstance as defined by the Director, or during the
annual | 7 | | Benefit Choice Period.
| 8 | | The Director shall annually determine monthly rates of | 9 | | payment subject to
the following constraints: for those | 10 | | community colleges with annuitants
only enrolled, first year | 11 | | rates shall be equal to the average cost to cover
claims for a | 12 | | State member adjusted for demographics, Medicare
| 13 | | participation, and other factors; and in the second year, a | 14 | | further adjustment
of rates shall be made to reflect the actual | 15 | | first year's claims experience
of the covered annuitants.
| 16 | | (l-5) The provisions of subsection (l) become inoperative | 17 | | on July 1, 1999.
| 18 | | (m) The Director shall adopt any rules deemed necessary for
| 19 | | implementation of this amendatory Act of 1989 (Public Act | 20 | | 86-978).
| 21 | | (n) Any child advocacy center within the State of Illinois | 22 | | may apply to the Director to have its employees, annuitants, | 23 | | and their dependents provided group health coverage under this | 24 | | Act on a non-insured basis. To participate, a child advocacy | 25 | | center must agree to enroll all of its employees and pay the | 26 | | entire cost of providing coverage for its employees. The child
|
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| 1 | | advocacy center shall not be required to enroll those of its
| 2 | | employees who are covered spouses or dependents under this plan
| 3 | | or another group policy or plan providing health benefits as
| 4 | | long as (1) an appropriate official from the child advocacy
| 5 | | center attests that each employee not enrolled is a covered
| 6 | | spouse or dependent under this plan or another group policy or
| 7 | | plan and (2) at least 50% of the employees are enrolled and the | 8 | | child advocacy center remits the entire cost of providing | 9 | | coverage to those employees. Employees of a participating child | 10 | | advocacy center who are not enrolled due to coverage under | 11 | | another group health policy or plan may enroll in the event of | 12 | | a qualifying change in status, special enrollment, or special | 13 | | circumstance as defined by the Director or during the annual | 14 | | Benefit Choice Period. A participating child advocacy center | 15 | | may also elect to cover its annuitants. Dependent coverage | 16 | | shall be offered on an optional basis, with the costs paid by | 17 | | the child advocacy center, its employees, or some combination | 18 | | of the 2 as determined by the child advocacy center. The child | 19 | | advocacy center shall be responsible for timely collection and | 20 | | transmission of dependent premiums. | 21 | | The Director shall annually determine rates of payment, | 22 | | subject to the following constraints: | 23 | | (1) In the first year of coverage, the rates shall be | 24 | | equal to the amount normally charged to State employees for | 25 | | elected optional coverages or for enrolled dependents | 26 | | coverages or other contributory coverages on behalf of its |
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| 1 | | employees, adjusted for differences between State | 2 | | employees and employees of the child advocacy center in | 3 | | age, sex, geographic location, or other relevant | 4 | | demographic variables, plus an amount sufficient to pay for | 5 | | the additional administrative costs of providing coverage | 6 | | to employees of the child advocacy center and their | 7 | | dependents. | 8 | | (2) In subsequent years, a further adjustment shall be | 9 | | made to reflect the actual prior years' claims experience | 10 | | of the employees of the child advocacy center. | 11 | | Monthly payments by the child advocacy center or its | 12 | | employees for group health insurance shall be deposited into | 13 | | the Local Government Health Insurance Reserve Fund. | 14 | | (Source: P.A. 95-331, eff. 8-21-07; 95-632, eff. 9-25-07; | 15 | | 95-707, eff. 1-11-08; 96-756, eff. 1-1-10; 96-1232, eff. | 16 | | 7-23-10; 96-1519, eff. 2-4-11.)
| 17 | | Section 99. Effective date. This Act takes effect July 1, | 18 | | 2012.
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