Full Text of HB6298 93rd General Assembly
HB6298 93RD GENERAL ASSEMBLY
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93RD GENERAL ASSEMBLY
State of Illinois
2003 and 2004 HB6298
Introduced 02/06/04, by Tom Cross SYNOPSIS AS INTRODUCED: |
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Amends the State Employees Group Insurance Act of 1971. Makes a technical
change in a Section concerning retired teacher benefits.
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A BILL FOR
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HB6298 |
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LRB093 15123 SAS 40718 b |
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| AN ACT concerning health benefits.
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| Be it enacted by the People of the State of Illinois, | 3 |
| represented in the General Assembly:
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| Section 5. The State Employees Group Insurance Act of 1971 | 5 |
| is amended by
changing Section 6.5 as follows:
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| (5 ILCS 375/6.5)
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| (Section scheduled to be repealed on July 1, 2004)
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| Sec. 6.5. Health benefits for TRS benefit recipients and | 9 |
| TRS dependent
beneficiaries.
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| (a) Purpose. It is The purpose of this amendatory Act of | 11 |
| 1995 is to
transfer
the administration of the program of health | 12 |
| benefits established for benefit
recipients and their | 13 |
| dependent beneficiaries under Article 16 of the Illinois
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| Pension Code to the Department of Central Management Services.
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| (b) Transition provisions. The Board of Trustees of the | 16 |
| Teachers'
Retirement System shall continue to administer the | 17 |
| health benefit program
established under Article 16 of the | 18 |
| Illinois Pension Code through December 31,
1995. Beginning | 19 |
| January 1, 1996, the Department of Central Management Services
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| shall be responsible for administering a program of health | 21 |
| benefits for TRS
benefit recipients and TRS dependent | 22 |
| beneficiaries under this Section.
The Department of Central | 23 |
| Management Services and the Teachers' Retirement
System shall | 24 |
| cooperate in this endeavor and shall coordinate their | 25 |
| activities
so as to ensure a smooth transition and | 26 |
| uninterrupted health benefit coverage.
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| (c) Eligibility. All persons who were enrolled in the | 28 |
| Article 16 program at
the time of the transfer shall be | 29 |
| eligible to participate in the program
established under this | 30 |
| Section without any interruption or delay in coverage
or | 31 |
| limitation as to pre-existing medical conditions. Eligibility | 32 |
| to
participate shall be determined by the Teachers' Retirement |
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HB6298 |
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LRB093 15123 SAS 40718 b |
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| System.
Eligibility information shall be communicated to the | 2 |
| Department of Central
Management Services in a format | 3 |
| acceptable to the Department.
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| A TRS dependent beneficiary who is an unmarried child age | 5 |
| 19 or over and
mentally or physically handicapped does not | 6 |
| become ineligible to participate
by reason of (i) becoming | 7 |
| ineligible to be claimed as a dependent for Illinois
or federal | 8 |
| income tax purposes or (ii) receiving earned income, so long as
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| those earnings are insufficient for the child to be fully | 10 |
| self-sufficient.
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| (d) Coverage. The level of health benefits provided under | 12 |
| this Section
shall be similar to the level of benefits provided | 13 |
| by the
program previously established under Article 16 of the | 14 |
| Illinois Pension Code.
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| Group life insurance benefits are not included in the | 16 |
| benefits
to be provided to TRS benefit recipients and TRS | 17 |
| dependent beneficiaries under
this Act.
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| The program of health benefits under this Section may | 19 |
| include any or all of
the benefit limitations, including but | 20 |
| not limited to a reduction in benefits
based on eligibility for | 21 |
| federal medicare benefits, that are provided under
subsection | 22 |
| (a) of Section 6 of this Act for other health benefit programs | 23 |
| under
this Act.
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| (e) Insurance rates and premiums. The Director shall | 25 |
| determine the
insurance rates and premiums for TRS benefit | 26 |
| recipients and TRS dependent
beneficiaries, and shall present | 27 |
| to the Teachers' Retirement System of
the State of Illinois, by | 28 |
| April 15 of each calendar year, the rate-setting
methodology | 29 |
| (including but not limited to utilization levels and costs) | 30 |
| used
to determine the amount of the health care premiums.
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| For Fiscal Year 1996, the premium shall be equal to the | 32 |
| premium actually
charged in Fiscal Year 1995; in subsequent | 33 |
| years, the premium shall
never be lower than the premium | 34 |
| charged in Fiscal Year 1995. For Fiscal Year
2003, the premium | 35 |
| shall not exceed 110% of the premium actually charged in
Fiscal | 36 |
| Year 2002. For Fiscal Year 2004, the premium shall not exceed |
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HB6298 |
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LRB093 15123 SAS 40718 b |
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| 112% of
the premium actually charged in Fiscal Year 2003.
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| Rates and premiums may be based in part on age and | 3 |
| eligibility for federal
medicare coverage. However, the cost of | 4 |
| participation for a TRS dependent
beneficiary who is an | 5 |
| unmarried child age 19 or over and mentally or physically
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| handicapped shall not exceed the cost for a TRS dependent | 7 |
| beneficiary who is
an unmarried child under age 19 and | 8 |
| participates in the same major medical or
managed care program.
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| The cost of health benefits under the program shall be paid | 10 |
| as follows:
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| (1) For a TRS benefit recipient selecting a managed | 12 |
| care program, up to
75% of the total insurance rate shall | 13 |
| be paid from the Teacher Health Insurance
Security Fund.
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| (2) For a TRS benefit recipient selecting the major | 15 |
| medical coverage
program, up to 50% of the total insurance | 16 |
| rate shall be paid from the Teacher
Health Insurance | 17 |
| Security Fund if a managed care program is accessible, as
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| determined by the Teachers' Retirement System.
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| (3) For a TRS benefit recipient selecting the major | 20 |
| medical coverage
program, up to 75% of the total insurance | 21 |
| rate shall be paid from the Teacher
Health Insurance | 22 |
| Security Fund if a managed care program is not accessible, | 23 |
| as
determined by the Teachers' Retirement System.
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| (4) The balance of the rate of insurance, including the | 25 |
| entire premium of
any coverage for TRS dependent | 26 |
| beneficiaries that has been elected, shall be
paid
by | 27 |
| deductions authorized by the TRS benefit recipient to be | 28 |
| withheld from his
or her monthly annuity or benefit payment | 29 |
| from the Teachers' Retirement System;
except that (i) if | 30 |
| the balance of the cost of coverage exceeds the amount of
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| the monthly annuity or benefit payment, the difference | 32 |
| shall be paid directly
to the Teachers' Retirement System | 33 |
| by the TRS benefit recipient, and (ii) all
or part of the | 34 |
| balance of the cost of coverage may, at the school board's
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| option, be paid to the Teachers' Retirement System by the | 36 |
| school board of the
school district from which the TRS |
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LRB093 15123 SAS 40718 b |
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| benefit recipient retired, in accordance
with Section | 2 |
| 10-22.3b of the School Code. The Teachers' Retirement | 3 |
| System
shall promptly deposit all moneys withheld by or | 4 |
| paid to it under this
subdivision (e)(4) into the Teacher | 5 |
| Health Insurance Security Fund. These
moneys shall not be | 6 |
| considered assets of the Retirement System.
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| (f) Financing. Beginning July 1, 1995, all revenues arising | 8 |
| from the
administration of the health benefit programs | 9 |
| established under Article 16 of
the Illinois Pension Code or | 10 |
| this Section shall be deposited into the
Teacher Health | 11 |
| Insurance Security Fund, which is hereby created as a
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| nonappropriated trust fund to be held outside the State | 13 |
| Treasury, with the
State Treasurer as custodian. Any interest | 14 |
| earned on moneys in the Teacher
Health Insurance Security Fund | 15 |
| shall be deposited into the Fund.
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| Moneys in the Teacher Health Insurance Security
Fund shall | 17 |
| be used only to pay the costs of the health benefit program
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| established under this Section, including associated | 19 |
| administrative costs, and
the costs associated with the health | 20 |
| benefit program established under Article
16 of the Illinois | 21 |
| Pension Code, as authorized in this Section. Beginning
July 1, | 22 |
| 1995, the Department of Central Management Services may make
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| expenditures from the Teacher Health Insurance Security Fund | 24 |
| for those costs.
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| After other funds authorized for the payment of the costs | 26 |
| of the health
benefit program established under Article 16 of | 27 |
| the Illinois Pension Code are
exhausted and until January 1, | 28 |
| 1996 (or such later date as may be agreed upon
by the Director | 29 |
| of Central Management Services and the Secretary of the
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| Teachers' Retirement System), the Secretary of the Teachers' | 31 |
| Retirement System
may make expenditures from the Teacher Health | 32 |
| Insurance Security Fund as
necessary to pay up to 75% of the | 33 |
| cost of providing health coverage to eligible
benefit | 34 |
| recipients (as defined in Sections 16-153.1 and 16-153.3 of the
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| Illinois Pension Code) who are enrolled in the Article 16 | 36 |
| health benefit
program and to facilitate the transfer of |
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LRB093 15123 SAS 40718 b |
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| administration of the health benefit
program to the Department | 2 |
| of Central Management Services.
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| (g) Contract for benefits. The Director shall by contract, | 4 |
| self-insurance,
or otherwise make available the program of | 5 |
| health benefits for TRS benefit
recipients and their TRS | 6 |
| dependent beneficiaries that is provided for in this
Section. | 7 |
| The contract or other arrangement for the provision of these | 8 |
| health
benefits shall be on terms deemed by the Director to be | 9 |
| in the best interest of
the State of Illinois and the TRS | 10 |
| benefit recipients based on, but not limited
to, such criteria | 11 |
| as administrative cost, service capabilities of the carrier
or | 12 |
| other contractor, and the costs of the benefits.
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| (h) Continuation and termination of program. It is the | 14 |
| intention of
the General Assembly that the program of health | 15 |
| benefits provided under this
Section be maintained on an | 16 |
| ongoing, affordable basis through June 30, 2004.
The program of | 17 |
| health benefits provided under this Section is terminated on
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| July 1, 2004.
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| The program of health benefits provided under this Section | 20 |
| may be amended by
the State and is not intended to be a pension | 21 |
| or retirement benefit subject to
protection under Article XIII, | 22 |
| Section 5 of the Illinois Constitution.
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| (i) Repeal. This Section is repealed on July 1, 2004.
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| (Source: P.A. 92-505, eff. 12-20-01; 92-862, eff. 1-3-03; | 25 |
| revised 1-10-03.)
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