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| [ Introduced ] | [ Engrossed ] | [ Senate Amendment 003 ] |
90_SB1921sam004
LRB9011685EGfgam02
1 AMENDMENT TO SENATE BILL 1921
2 AMENDMENT NO. . Amend Senate Bill 1921, AS AMENDED,
3 by replacing the title with the following:
4 "AN ACT in relation to public employee benefits, amending
5 named Acts."; and
6 by replacing everything after the enacting clause with the
7 following:
8 "Section 5. The State Employees Group Insurance Act of
9 1971 is amended by changing Sections 3 and 10 as follows:
10 (5 ILCS 375/3) (from Ch. 127, par. 523)
11 Sec. 3. Definitions. Unless the context otherwise
12 requires, the following words and phrases as used in this Act
13 shall have the following meanings. The Department may define
14 these and other words and phrases separately for the purpose
15 of implementing specific programs providing benefits under
16 this Act.
17 (a) "Administrative service organization" means any
18 person, firm or corporation experienced in the handling of
19 claims which is fully qualified, financially sound and
20 capable of meeting the service requirements of a contract of
21 administration executed with the Department.
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1 (b) "Annuitant" means (1) an employee who retires, or
2 has retired, on or after January 1, 1966 on an immediate
3 annuity under the provisions of Articles 2, 14, 15 (including
4 an employee who has retired under the optional retirement
5 program established under Section 15-158.2), paragraphs (2),
6 (3), or (5) of Section 16-106, or Article 18 of the Illinois
7 Pension Code; (2) any person who was receiving group
8 insurance coverage under this Act as of March 31, 1978 by
9 reason of his status as an annuitant, even though the annuity
10 in relation to which such coverage was provided is a
11 proportional annuity based on less than the minimum period of
12 service required for a retirement annuity in the system
13 involved; (3) any person not otherwise covered by this Act
14 who has retired as a participating member under Article 2 of
15 the Illinois Pension Code but is ineligible for the
16 retirement annuity under Section 2-119 of the Illinois
17 Pension Code; (4) the spouse of any person who is receiving a
18 retirement annuity under Article 18 of the Illinois Pension
19 Code and who is covered under a group health insurance
20 program sponsored by a governmental employer other than the
21 State of Illinois and who has irrevocably elected to waive
22 his or her coverage under this Act and to have his or her
23 spouse considered as the "annuitant" under this Act and not
24 as a "dependent"; or (5) an employee who retires, or has
25 retired, from a qualified position, as determined according
26 to rules promulgated by the Director, under a qualified local
27 government or a qualified rehabilitation facility or a
28 qualified domestic violence shelter or service. (For
29 definition of "retired employee", see (p) post).
30 (b-5) "New SERS annuitant" means a person who, on or
31 after January 1, 1998, becomes an annuitant, as defined in
32 subsection (b), by virtue of beginning to receive a
33 retirement annuity under Article 14 of the Illinois Pension
34 Code, and is eligible to participate in the basic program of
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1 group health benefits provided for annuitants under this Act.
2 (b-6) "New SURS annuitant" means a person who (1), on or
3 after January 1, 1998, becomes an annuitant, as defined in
4 subsection (b), by virtue of beginning to receive a
5 retirement annuity under Article 15 of the Illinois Pension
6 Code, (2) has not made the election authorized under Section
7 15-135.1 of the Illinois Pension Code, and (3) is eligible to
8 participate in the basic program of group health benefits
9 provided for annuitants under this Act.
10 (b-7) "New TRS State annuitant" means a person who, on
11 or after July 1, 1998, becomes an annuitant, as defined in
12 subsection (b), by virtue of beginning to receive a
13 retirement annuity under Article 16 of the Illinois Pension
14 Code based on service as a teacher as defined in paragraph
15 (2), (3), or (5) of Section 16-106 of that Code, and is
16 eligible to participate in the basic program of group health
17 benefits provided for annuitants under this Act.
18 (c) "Carrier" means (1) an insurance company, a
19 corporation organized under the Limited Health Service
20 Organization Act or the Voluntary Health Services Plan Act, a
21 partnership, or other nongovernmental organization, which is
22 authorized to do group life or group health insurance
23 business in Illinois, or (2) the State of Illinois as a
24 self-insurer.
25 (d) "Compensation" means salary or wages payable on a
26 regular payroll by the State Treasurer on a warrant of the
27 State Comptroller out of any State, trust or federal fund, or
28 by the Governor of the State through a disbursing officer of
29 the State out of a trust or out of federal funds, or by any
30 Department out of State, trust, federal or other funds held
31 by the State Treasurer or the Department, to any person for
32 personal services currently performed, and ordinary or
33 accidental disability benefits under Articles 2, 14, 15
34 (including ordinary or accidental disability benefits under
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1 the optional retirement program established under Section
2 15-158.2), paragraphs (2), (3), or (5) of Section 16-106, or
3 Article 18 of the Illinois Pension Code, for disability
4 incurred after January 1, 1966, or benefits payable under the
5 Workers' Compensation or Occupational Diseases Act or
6 benefits payable under a sick pay plan established in
7 accordance with Section 36 of the State Finance Act.
8 "Compensation" also means salary or wages paid to an employee
9 of any qualified local government or qualified rehabilitation
10 facility or a qualified domestic violence shelter or service.
11 (e) "Commission" means the State Employees Group
12 Insurance Advisory Commission authorized by this Act.
13 Commencing July 1, 1984, "Commission" as used in this Act
14 means the Illinois Economic and Fiscal Commission as
15 established by the Legislative Commission Reorganization Act
16 of 1984.
17 (f) "Contributory", when referred to as contributory
18 coverage, shall mean optional coverages or benefits elected
19 by the member toward the cost of which such member makes
20 contribution, or which are funded in whole or in part through
21 the acceptance of a reduction in earnings or the foregoing of
22 an increase in earnings by an employee, as distinguished from
23 noncontributory coverage or benefits which are paid entirely
24 by the State of Illinois without reduction of the member's
25 salary.
26 (g) "Department" means any department, institution,
27 board, commission, officer, court or any agency of the State
28 government receiving appropriations and having power to
29 certify payrolls to the Comptroller authorizing payments of
30 salary and wages against such appropriations as are made by
31 the General Assembly from any State fund, or against trust
32 funds held by the State Treasurer and includes boards of
33 trustees of the retirement systems created by Articles 2, 14,
34 15, 16 and 18 of the Illinois Pension Code. "Department"
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1 also includes the Illinois Comprehensive Health Insurance
2 Board, the Board of Examiners established under the Illinois
3 Public Accounting Act, and the Illinois Rural Bond Bank.
4 (h) "Dependent", when the term is used in the context of
5 the health and life plan, means a member's spouse and any
6 unmarried child (1) from birth to age 19 including an adopted
7 child, a child who lives with the member from the time of the
8 filing of a petition for adoption until entry of an order of
9 adoption, a stepchild or recognized child who lives with the
10 member in a parent-child relationship, or a child who lives
11 with the member if such member is a court appointed guardian
12 of the child, or (2) age 19 to 23 enrolled as a full-time
13 student in any accredited school, financially dependent upon
14 the member, and eligible as a dependent for Illinois State
15 income tax purposes, or (3) age 19 or over who is mentally or
16 physically handicapped as defined in the Illinois Insurance
17 Code. For the health plan only, the term "dependent" also
18 includes any person enrolled prior to the effective date of
19 this Section who is dependent upon the member to the extent
20 that the member may claim such person as a dependent for
21 Illinois State income tax deduction purposes; no other such
22 person may be enrolled.
23 (i) "Director" means the Director of the Illinois
24 Department of Central Management Services.
25 (j) "Eligibility period" means the period of time a
26 member has to elect enrollment in programs or to select
27 benefits without regard to age, sex or health.
28 (k) "Employee" means and includes each officer or
29 employee in the service of a department who (1) receives his
30 compensation for service rendered to the department on a
31 warrant issued pursuant to a payroll certified by a
32 department or on a warrant or check issued and drawn by a
33 department upon a trust, federal or other fund or on a
34 warrant issued pursuant to a payroll certified by an elected
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1 or duly appointed officer of the State or who receives
2 payment of the performance of personal services on a warrant
3 issued pursuant to a payroll certified by a Department and
4 drawn by the Comptroller upon the State Treasurer against
5 appropriations made by the General Assembly from any fund or
6 against trust funds held by the State Treasurer, and (2) is
7 employed full-time or part-time in a position normally
8 requiring actual performance of duty during not less than 1/2
9 of a normal work period, as established by the Director in
10 cooperation with each department, except that persons elected
11 by popular vote will be considered employees during the
12 entire term for which they are elected regardless of hours
13 devoted to the service of the State, and (3) except that
14 "employee" does not include any person who is not eligible by
15 reason of such person's employment to participate in one of
16 the State retirement systems under Articles 2, 14, 15 (either
17 the regular Article 15 system or the optional retirement
18 program established under Section 15-158.2) or 18, or under
19 paragraph (2), (3), or (5) of Section 16-106, of the Illinois
20 Pension Code, but such term does include persons who are
21 employed during the 6 month qualifying period under Article
22 14 of the Illinois Pension Code. Such term also includes any
23 person who (1) after January 1, 1966, is receiving ordinary
24 or accidental disability benefits under Articles 2, 14, 15
25 (including ordinary or accidental disability benefits under
26 the optional retirement program established under Section
27 15-158.2), paragraphs (2), (3), or (5) of Section 16-106, or
28 Article 18 of the Illinois Pension Code, for disability
29 incurred after January 1, 1966, (2) receives total permanent
30 or total temporary disability under the Workers' Compensation
31 Act or Occupational Disease Act as a result of injuries
32 sustained or illness contracted in the course of employment
33 with the State of Illinois, or (3) is not otherwise covered
34 under this Act and has retired as a participating member
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1 under Article 2 of the Illinois Pension Code but is
2 ineligible for the retirement annuity under Section 2-119 of
3 the Illinois Pension Code. However, a person who satisfies
4 the criteria of the foregoing definition of "employee" except
5 that such person is made ineligible to participate in the
6 State Universities Retirement System by clause (4) of
7 subsection (a) of Section 15-107 of the Illinois Pension Code
8 is also an "employee" for the purposes of this Act.
9 "Employee" also includes any person receiving or eligible for
10 benefits under a sick pay plan established in accordance with
11 Section 36 of the State Finance Act. "Employee" also includes
12 each officer or employee in the service of a qualified local
13 government, including persons appointed as trustees of
14 sanitary districts regardless of hours devoted to the service
15 of the sanitary district, and each employee in the service of
16 a qualified rehabilitation facility and each full-time
17 employee in the service of a qualified domestic violence
18 shelter or service, as determined according to rules
19 promulgated by the Director.
20 (l) "Member" means an employee, annuitant, retired
21 employee or survivor.
22 (m) "Optional coverages or benefits" means those
23 coverages or benefits available to the member on his or her
24 voluntary 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
27 for by the Director under this Act.
28 (o) "Health plan" means a self-insured health insurance
29 program offered by the State of Illinois for the purposes of
30 benefiting employees by means of providing, among others,
31 wellness programs, utilization reviews, second opinions and
32 medical fee reviews, as well as for paying for hospital and
33 medical care up to the maximum coverage provided by the plan,
34 to its members and their dependents.
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1 (p) "Retired employee" means any person who would be an
2 annuitant as that term is defined herein but for the fact
3 that such person retired prior to January 1, 1966. Such term
4 also includes any person formerly employed by the University
5 of Illinois in the Cooperative Extension Service who would be
6 an annuitant but for the fact that such person was made
7 ineligible to participate in the State Universities
8 Retirement System by clause (4) of subsection (a) of Section
9 15-107 of the Illinois Pension Code.
10 (p-6) "New SURS retired employee" means a person who, on
11 or after January 1, 1998, becomes a retired employee, as
12 defined in subsection (p), by virtue of being a person
13 formerly employed by the University of Illinois in the
14 Cooperative Extension Service who would be an annuitant but
15 for the fact that he or she was made ineligible to
16 participate in the State Universities Retirement System by
17 clause (4) of subsection (a) of Section 15-107 of the
18 Illinois Pension Code, and who is eligible to participate in
19 the basic program of group health benefits provided for
20 retired employees under this Act.
21 (q) "Survivor" means a person receiving an annuity as a
22 survivor of an employee or of an annuitant. "Survivor" also
23 includes: (1) the surviving dependent of a person who
24 satisfies the definition of "employee" except that such
25 person is made ineligible to participate in the State
26 Universities Retirement System by clause (4) of subsection
27 (a) of Section 15-107 of the Illinois Pension Code; and (2)
28 the surviving dependent of any person formerly employed by
29 the University of Illinois in the Cooperative Extension
30 Service who would be an annuitant except for the fact that
31 such person was made ineligible to participate in the State
32 Universities Retirement System by clause (4) of subsection
33 (a) of Section 15-107 of the Illinois Pension Code.
34 (q-5) "New SERS survivor" means a survivor, as defined
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1 in subsection (q), whose annuity is paid under Article 14 of
2 the Illinois Pension Code and is based on the death of (i) an
3 employee whose death occurs on or after January 1, 1998, or
4 (ii) a new SERS annuitant as defined in subsection (b-5).
5 (q-6) "New SURS survivor" means a survivor, as defined
6 in subsection (q), whose annuity is paid under Article 15 of
7 the Illinois Pension Code and is based on the death of (i) an
8 employee whose death occurs on or after January 1, 1998, or
9 (ii) a new SURS annuitant as defined in subsection (b-6), or
10 (iii) a new SURS retired employee as defined in subsection
11 (p-6).
12 (q-7) "New TRS State survivor" means a survivor, as
13 defined in subsection (q), whose annuity is paid under
14 Article 16 of the Illinois Pension Code and is based on the
15 death of (i) an employee who is a teacher as defined in
16 paragraph (2), (3), or (5) of Section 16-106 of that Code and
17 whose death occurs on or after July 1, 1998, or (ii) a new
18 TRS State annuitant as defined in subsection (b-7).
19 (r) "Medical services" means the services provided
20 within the scope of their licenses by practitioners in all
21 categories licensed under the Medical Practice Act of 1987.
22 (s) "Unit of local government" means any county,
23 municipality, township, school district, special district or
24 other unit, designated as a unit of local government by law,
25 which exercises limited governmental powers or powers in
26 respect to limited governmental subjects, any not-for-profit
27 association with a membership that primarily includes
28 townships and township officials, that has duties that
29 include provision of research service, dissemination of
30 information, and other acts for the purpose of improving
31 township government, and that is funded wholly or partly in
32 accordance with Section 85-15 of the Township Code; any
33 not-for-profit corporation or association, with a membership
34 consisting primarily of municipalities, that operates its own
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1 utility system, and provides research, training,
2 dissemination of information, or other acts to promote
3 cooperation between and among municipalities that provide
4 utility services and for the advancement of the goals and
5 purposes of its membership; and the Illinois Association of
6 Park Districts. "Qualified local government" means a unit of
7 local government approved by the Director and participating
8 in a program created under subsection (i) of Section 10 of
9 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
14 to the Department of Mental Health and Developmental
15 Disabilities) to provide services to persons with
16 disabilities and which receives funds from the State of
17 Illinois for providing those services, approved by the
18 Director and participating in a program created under
19 subsection (j) of Section 10 of this Act.
20 (u) "Qualified domestic violence shelter or service"
21 means any Illinois domestic violence shelter or service and
22 its 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:
27 (1) is not a "member" as defined in this Section;
28 and
29 (2) is receiving a monthly benefit or retirement
30 annuity under Article 16 of the Illinois Pension Code;
31 and
32 (3) either (i) has at least 8 years of creditable
33 service under Article 16 of the Illinois Pension Code, or
34 (ii) was enrolled in the health insurance program offered
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1 under that Article on January 1, 1996, or (iii) is the
2 survivor of a benefit recipient who had at least 8 years
3 of creditable service under Article 16 of the Illinois
4 Pension Code or was enrolled in the health insurance
5 program offered under that Article on the effective date
6 of this amendatory Act of 1995, or (iv) is a recipient or
7 survivor of a recipient of a disability benefit under
8 Article 16 of the Illinois Pension Code.
9 (w) "TRS dependent beneficiary" means a person who:
10 (1) is not a "member" or "dependent" as defined in
11 this Section; and
12 (2) is a TRS benefit recipient's: (A) spouse, (B)
13 dependent parent who is receiving at least half of his or
14 her support from the TRS benefit recipient, or (C)
15 unmarried natural or adopted child who is (i) under age
16 19, or (ii) enrolled as a full-time student in an
17 accredited school, financially dependent upon the TRS
18 benefit recipient, eligible as a dependent for Illinois
19 State income tax purposes, and either is under age 24 or
20 was, on January 1, 1996, participating as a dependent
21 beneficiary in the health insurance program offered under
22 Article 16 of the Illinois Pension Code, or (iii) age 19
23 or over who is mentally or physically handicapped as
24 defined in the Illinois Insurance Code.
25 (x) "Military leave with pay and benefits" refers to
26 individuals in basic training for reserves, special/advanced
27 training, annual training, emergency call up, or activation
28 by the President of the United States with approved pay and
29 benefits.
30 (y) "Military leave without pay and benefits" refers to
31 individuals who enlist for active duty in a regular component
32 of the U.S. Armed Forces or other duty not specified or
33 authorized under military leave with pay and benefits.
34 (z) "Community college benefit recipient" means a person
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1 who:
2 (1) is not a "member" as defined in this Section;
3 and
4 (2) is receiving a monthly survivor's annuity or
5 retirement annuity under Article 15 of the Illinois
6 Pension Code; and
7 (3) either (i) was a full-time employee of a
8 community college district or an association of community
9 college boards created under the Public Community College
10 Act (other than an employee whose last employer under
11 Article 15 of the Illinois Pension Code was a community
12 college district subject to Article VII of the Public
13 Community College Act) and was eligible to participate in
14 a group health benefit plan as an employee during the
15 time of employment with a community college district
16 (other than a community college district subject to
17 Article VII of the Public Community College Act) or an
18 association of community college boards, or (ii) is the
19 survivor of a person described in item (i).
20 (aa) "Community college dependent beneficiary" means a
21 person who:
22 (1) is not a "member" or "dependent" as defined in
23 this Section; and
24 (2) is a community college benefit recipient's: (A)
25 spouse, (B) dependent parent who is receiving at least
26 half of his or her support from the community college
27 benefit recipient, or (C) unmarried natural or adopted
28 child who is (i) under age 19, or (ii) enrolled as a
29 full-time student in an accredited school, financially
30 dependent upon the community college benefit recipient,
31 eligible as a dependent for Illinois State income tax
32 purposes and under age 23, or (iii) age 19 or over and
33 mentally or physically handicapped as defined in the
34 Illinois Insurance Code.
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1 (Source: P.A. 89-21, eff. 6-21-95; 89-25, eff. 6-21-95;
2 89-76, eff. 7-1-95; 89-324, eff. 8-13-95; 89-430, eff.
3 12-15-95; 89-502, eff. 7-1-96; 89-507, eff. 7-1-97; 89-628,
4 eff. 8-9-96; 90-14, eff. 7-1-97; 90-65, eff. 7-7-97; 90-448,
5 eff. 8-16-97; 90-497, eff. 8-18-97; 90-511, eff. 8-22-97;
6 90-582, eff. 5-27-98; 90-655, eff. 7-30-98.)
7 (5 ILCS 375/10) (from Ch. 127, par. 530)
8 Sec. 10. Payments by State; premiums.
9 (a) The State shall pay the cost of basic
10 non-contributory group life insurance and, subject to member
11 paid contributions set by the Department or required by this
12 Section, the basic program of group health benefits on each
13 eligible member, except a member, not otherwise covered by
14 this Act, who has retired as a participating member under
15 Article 2 of the Illinois Pension Code but is ineligible for
16 the retirement annuity under Section 2-119 of the Illinois
17 Pension Code, and part of each eligible member's and retired
18 member's premiums for health insurance coverage for enrolled
19 dependents as provided by Section 9. The State shall pay the
20 cost of the basic program of group health benefits only after
21 benefits are reduced by the amount of benefits covered by
22 Medicare for all retired members and retired dependents aged
23 65 years or older who are entitled to benefits under Social
24 Security or the Railroad Retirement system or who had
25 sufficient Medicare-covered government employment except that
26 such reduction in benefits shall apply only to those retired
27 members or retired dependents who (1) first become eligible
28 for such Medicare coverage on or after July 1, 1992; or (2)
29 remain eligible for, but no longer receive Medicare coverage
30 which they had been receiving on or after July 1, 1992. The
31 Department may determine the aggregate level of the State's
32 contribution on the basis of actual cost of medical services
33 adjusted for age, sex or geographic or other demographic
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1 characteristics which affect the costs of such programs.
2 The cost of participation in the basic program of group
3 health benefits for the dependent or survivor of a living or
4 deceased retired employee who was formerly employed by the
5 University of Illinois in the Cooperative Extension Service
6 and would be an annuitant but for the fact that he or she was
7 made ineligible to participate in the State Universities
8 Retirement System by clause (4) of subsection (a) of Section
9 15-107 of the Illinois Pension Code shall not be greater than
10 the cost of participation that would otherwise apply to that
11 dependent or survivor if he or she were the dependent or
12 survivor of an annuitant under the State Universities
13 Retirement System.
14 (a-1) Beginning January 1, 1998, for each person who
15 becomes a new SERS annuitant and participates in the basic
16 program of group health benefits, the State shall contribute
17 toward the cost of the annuitant's coverage under the basic
18 program of group health benefits an amount equal to 5% of
19 that cost for each full year of creditable service upon which
20 the annuitant's retirement annuity is based, up to a maximum
21 of 100% for an annuitant with 20 or more years of creditable
22 service. The remainder of the cost of a new SERS annuitant's
23 coverage under the basic program of group health benefits
24 shall be the responsibility of the annuitant, except as
25 provided in subsection (a-10).
26 (a-2) Beginning January 1, 1998, for each person who
27 becomes a new SERS survivor and participates in the basic
28 program of group health benefits, the State shall contribute
29 toward the cost of the survivor's coverage under the basic
30 program of group health benefits an amount equal to 5% of
31 that cost for each full year of the deceased employee's or
32 deceased annuitant's creditable service in the State
33 Employees' Retirement System of Illinois on the date of
34 death, up to a maximum of 100% for a survivor of an employee
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1 or annuitant with 20 or more years of creditable service.
2 The remainder of the cost of the new SERS survivor's coverage
3 under the basic program of group health benefits shall be the
4 responsibility of the survivor, except as provided in
5 subsection (a-10).
6 (a-3) Beginning January 1, 1998, for each person who
7 becomes a new SURS annuitant and participates in the basic
8 program of group health benefits, the State shall contribute
9 toward the cost of the annuitant's coverage under the basic
10 program of group health benefits an amount equal to 5% of
11 that cost for each full year of creditable service upon which
12 the annuitant's retirement annuity is based, up to a maximum
13 of 100% for an annuitant with 20 or more years of creditable
14 service. The remainder of the cost of a new SURS annuitant's
15 coverage under the basic program of group health benefits
16 shall be the responsibility of the annuitant, except as
17 provided in subsection (a-10).
18 (a-4) (Blank). Beginning January 1, 1998, for each
19 person who becomes a new SURS retired employee and
20 participates in the basic program of group health benefits,
21 the State shall contribute toward the cost of the retired
22 employee's coverage under the basic program of group health
23 benefits an amount equal to 5% of that cost for each full
24 year that the retired employee was an employee as defined in
25 Section 3, up to a maximum of 100% for a retired employee who
26 was an employee for 20 or more years. The remainder of the
27 cost of a new SURS retired employee's coverage under the
28 basic program of group health benefits shall be the
29 responsibility of the retired employee.
30 (a-5) Beginning January 1, 1998, for each person who
31 becomes a new SURS survivor and participates in the basic
32 program of group health benefits, the State shall contribute
33 toward the cost of the survivor's coverage under the basic
34 program of group health benefits an amount equal to 5% of
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1 that cost for each full year of the deceased employee's or
2 deceased annuitant's creditable service in the State
3 Universities Retirement System on the date of death, up to a
4 maximum of 100% for a survivor of an employee or annuitant
5 with 20 or more years of creditable service. The remainder
6 of the cost of the new SURS survivor's coverage under the
7 basic program of group health benefits shall be the
8 responsibility of the survivor, except as provided in
9 subsection (a-10).
10 (a-6) Beginning July 1, 1998, for each person who
11 becomes a new TRS State annuitant and participates in the
12 basic program of group health benefits, the State shall
13 contribute toward the cost of the annuitant's coverage under
14 the basic program of group health benefits an amount equal to
15 5% of that cost for each full year of creditable service as a
16 teacher as defined in paragraph (2), (3), or (5) of Section
17 16-106 of the Illinois Pension Code upon which the
18 annuitant's retirement annuity is based, up to a maximum of
19 100% for an annuitant with 20 or more years of such
20 creditable service. The remainder of the cost of a new TRS
21 State annuitant's coverage under the basic program of group
22 health benefits shall be the responsibility of the annuitant.
23 (a-7) Beginning July 1, 1998, for each person who
24 becomes a new TRS State survivor and participates in the
25 basic program of group health benefits, the State shall
26 contribute toward the cost of the survivor's coverage under
27 the basic program of group health benefits an amount equal to
28 5% of that cost for each full year of the deceased employee's
29 or deceased annuitant's creditable service as a teacher as
30 defined in paragraph (2), (3), or (5) of Section 16-106 of
31 the Illinois Pension Code on the date of death, up to a
32 maximum of 100% for a survivor of an employee or annuitant
33 with 20 or more years of such creditable service. The
34 remainder of the cost of the new TRS State survivor's
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1 coverage under the basic program of group health benefits
2 shall be the responsibility of the survivor.
3 (a-8) A new SERS annuitant, new SERS survivor, new SURS
4 annuitant, new SURS retired employee, new SURS survivor, new
5 TRS State annuitant, or new TRS State survivor may waive or
6 terminate coverage in the program of group health benefits.
7 Any such annuitant or, survivor, or retired employee who has
8 waived or terminated coverage may enroll or re-enroll in the
9 program of group health benefits only during the annual
10 benefit choice period, as determined by the Director; except
11 that in the event of termination of coverage due to
12 nonpayment of premiums, the annuitant or, survivor, or
13 retired employee may not re-enroll in the program.
14 (a-9) No later than May 1 of each calendar year, the
15 Director of Central Management Services shall certify in
16 writing to the Executive Secretary of the State Employees'
17 Retirement System of Illinois the amounts of the Medicare
18 supplement health care premiums and the amounts of the health
19 care premiums for all other retirees who are not Medicare
20 eligible.
21 A separate calculation of the premiums based upon the
22 actual cost of each health care plan shall be so certified.
23 The Director of Central Management Services shall provide
24 to the Executive Secretary of the State Employees' Retirement
25 System of Illinois such information, statistics, and other
26 data as he or she may require to review the premium amounts
27 certified by the Director of Central Management Services.
28 (b) State employees who become eligible for this program
29 on or after January 1, 1980 in positions normally requiring
30 actual performance of duty not less than 1/2 of a normal work
31 period but not equal to that of a normal work period, shall
32 be given the option of participating in the available
33 program. If the employee elects coverage, the State shall
34 contribute on behalf of such employee to the cost of the
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1 employee's benefit and any applicable dependent supplement,
2 that sum which bears the same percentage as that percentage
3 of time the employee regularly works when compared to normal
4 work period.
5 (c) The basic non-contributory coverage from the basic
6 program of group health benefits shall be continued for each
7 employee not in pay status or on active service by reason of
8 (1) leave of absence due to illness or injury, (2) authorized
9 educational leave of absence or sabbatical leave, or (3)
10 military leave with pay and benefits. This coverage shall
11 continue until expiration of authorized leave and return to
12 active service, but not to exceed 24 months for leaves under
13 item (1) or (2). This 24-month limitation and the requirement
14 of returning to active service shall not apply to persons
15 receiving ordinary or accidental disability benefits or
16 retirement benefits through the appropriate State retirement
17 system or benefits under the Workers' Compensation or
18 Occupational Disease Act.
19 (d) The basic group life insurance coverage shall
20 continue, with full State contribution, where such person is
21 (1) absent from active service by reason of disability
22 arising from any cause other than self-inflicted, (2) on
23 authorized educational leave of absence or sabbatical leave,
24 or (3) on military leave with pay and benefits.
25 (e) Where the person is in non-pay status for a period
26 in excess of 30 days or on leave of absence, other than by
27 reason of disability, educational or sabbatical leave, or
28 military leave with pay and benefits, such person may
29 continue coverage only by making personal payment equal to
30 the amount normally contributed by the State on such person's
31 behalf. Such payments and coverage may be continued: (1)
32 until such time as the person returns to a status eligible
33 for coverage at State expense, but not to exceed 24 months,
34 (2) until such person's employment or annuitant status with
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1 the State is terminated, or (3) for a maximum period of 4
2 years for members on military leave with pay and benefits and
3 military leave without pay and benefits (exclusive of any
4 additional service imposed pursuant to law).
5 (f) The Department shall establish by rule the extent
6 to which other employee benefits will continue for persons in
7 non-pay status or who are not in active service.
8 (g) The State shall not pay the cost of the basic
9 non-contributory group life insurance, program of health
10 benefits and other employee benefits for members who are
11 survivors as defined by paragraphs (1) and (2) of subsection
12 (q) of Section 3 of this Act. The costs of benefits for
13 these survivors shall be paid by the survivors or by the
14 University of Illinois Cooperative Extension Service, or any
15 combination thereof. However, the State shall pay the amount
16 of the reduction in the cost of participation, if any,
17 resulting from the amendment to subsection (a) made by this
18 amendatory Act of 1998.
19 (h) Those persons occupying positions with any
20 department as a result of emergency appointments pursuant to
21 Section 8b.8 of the Personnel Code who are not considered
22 employees under this Act shall be given the option of
23 participating in the programs of group life insurance, health
24 benefits and other employee benefits. Such persons electing
25 coverage may participate only by making payment equal to the
26 amount normally contributed by the State for similarly
27 situated employees. Such amounts shall be determined by the
28 Director. Such payments and coverage may be continued until
29 such time as the person becomes an employee pursuant to this
30 Act or such person's appointment is terminated.
31 (i) Any unit of local government within the State of
32 Illinois may apply to the Director to have its employees,
33 annuitants, and their dependents provided group health
34 coverage under this Act on a non-insured basis. To
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1 participate, a unit of local government must agree to enroll
2 all of its employees, who may select coverage under either
3 the State group health insurance plan or a health maintenance
4 organization that has contracted with the State to be
5 available as a health care provider for employees as defined
6 in this Act. A unit of local government must remit the
7 entire cost of providing coverage under the State group
8 health insurance plan or, for coverage under a health
9 maintenance organization, an amount determined by the
10 Director based on an analysis of the sex, age, geographic
11 location, or other relevant demographic variables for its
12 employees, except that the unit of local government shall not
13 be required to enroll those of its employees who are covered
14 spouses or dependents under this plan or another group policy
15 or plan providing health benefits as long as (1) an
16 appropriate official from the unit of local government
17 attests that each employee not enrolled is a covered spouse
18 or dependent under this plan or another group policy or plan,
19 and (2) at least 85% of the employees are enrolled and the
20 unit of local government remits the entire cost of providing
21 coverage to those employees. Employees of a participating
22 unit of local government who are not enrolled due to coverage
23 under another group health policy or plan may enroll at a
24 later date subject to submission of satisfactory evidence of
25 insurability and provided that no benefits shall be payable
26 for services incurred during the first 6 months of coverage
27 to the extent the services are in connection with any
28 pre-existing condition. A participating unit of local
29 government may also elect to cover its annuitants. Dependent
30 coverage shall be offered on an optional basis, with the
31 costs paid by the unit of local government, its employees, or
32 some combination of the two as determined by the unit of
33 local government. The unit of local government shall be
34 responsible for timely collection and transmission of
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1 dependent premiums.
2 The Director shall annually determine monthly rates of
3 payment, subject to the following constraints:
4 (1) In the first year of coverage, the rates shall
5 be equal to the amount normally charged to State
6 employees for elected optional coverages or for enrolled
7 dependents coverages or other contributory coverages, or
8 contributed by the State for basic insurance coverages on
9 behalf of its employees, adjusted for differences between
10 State employees and employees of the local government in
11 age, sex, geographic location or other relevant
12 demographic variables, plus an amount sufficient to pay
13 for the additional administrative costs of providing
14 coverage to employees of the unit of local government and
15 their dependents.
16 (2) In subsequent years, a further adjustment shall
17 be made to reflect the actual prior years' claims
18 experience of the employees of the unit of local
19 government.
20 In the case of coverage of local government employees
21 under a health maintenance organization, the Director shall
22 annually determine for each participating unit of local
23 government the maximum monthly amount the unit may contribute
24 toward that coverage, based on an analysis of (i) the age,
25 sex, geographic location, and other relevant demographic
26 variables of the unit's employees and (ii) the cost to cover
27 those employees under the State group health insurance plan.
28 The Director may similarly determine the maximum monthly
29 amount each unit of local government may contribute toward
30 coverage of its employees' dependents under a health
31 maintenance organization.
32 Monthly payments by the unit of local government or its
33 employees for group health insurance or health maintenance
34 organization coverage shall be deposited in the Local
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1 Government Health Insurance Reserve Fund. The Local
2 Government Health Insurance Reserve Fund shall be a
3 continuing fund not subject to fiscal year limitations. All
4 expenditures from this fund shall be used for payments for
5 health care benefits for local government and rehabilitation
6 facility employees, annuitants, and dependents, and to
7 reimburse the Department or its administrative service
8 organization for all expenses incurred in the administration
9 of benefits. No other State funds may be used for these
10 purposes.
11 A local government employer's participation or desire to
12 participate in a program created under this subsection shall
13 not limit that employer's duty to bargain with the
14 representative of any collective bargaining unit of its
15 employees.
16 (j) Any rehabilitation facility within the State of
17 Illinois may apply to the Director to have its employees,
18 annuitants, and their dependents provided group health
19 coverage under this Act on a non-insured basis. To
20 participate, a rehabilitation facility must agree to enroll
21 all of its employees and remit the entire cost of providing
22 such coverage for its employees, except that the
23 rehabilitation facility shall not be required to enroll those
24 of its employees who are covered spouses or dependents under
25 this plan or another group policy or plan providing health
26 benefits as long as (1) an appropriate official from the
27 rehabilitation facility attests that each employee not
28 enrolled is a covered spouse or dependent under this plan or
29 another group policy or plan, and (2) at least 85% of the
30 employees are enrolled and the rehabilitation facility remits
31 the entire cost of providing coverage to those employees.
32 Employees of a participating rehabilitation facility who are
33 not enrolled due to coverage under another group health
34 policy or plan may enroll at a later date subject to
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1 submission of satisfactory evidence of insurability and
2 provided that no benefits shall be payable for services
3 incurred during the first 6 months of coverage to the extent
4 the services are in connection with any pre-existing
5 condition. A participating rehabilitation facility may also
6 elect to cover its annuitants. Dependent coverage shall be
7 offered on an optional basis, with the costs paid by the
8 rehabilitation facility, its employees, or some combination
9 of the 2 as determined by the rehabilitation facility. The
10 rehabilitation facility shall be responsible for timely
11 collection and transmission of dependent premiums.
12 The Director shall annually determine quarterly rates of
13 payment, subject to the following constraints:
14 (1) In the first year of coverage, the rates shall
15 be equal to the amount normally charged to State
16 employees for elected optional coverages or for enrolled
17 dependents coverages or other contributory coverages on
18 behalf of its employees, adjusted for differences between
19 State employees and employees of the rehabilitation
20 facility in age, sex, geographic location or other
21 relevant demographic variables, plus an amount sufficient
22 to pay for the additional administrative costs of
23 providing coverage to employees of the rehabilitation
24 facility and their dependents.
25 (2) In subsequent years, a further adjustment shall
26 be made to reflect the actual prior years' claims
27 experience of the employees of the rehabilitation
28 facility.
29 Monthly payments by the rehabilitation facility or its
30 employees for group health insurance shall be deposited in
31 the Local Government Health Insurance Reserve Fund.
32 (k) Any domestic violence shelter or service within the
33 State of Illinois may apply to the Director to have its
34 employees, annuitants, and their dependents provided group
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1 health coverage under this Act on a non-insured basis. To
2 participate, a domestic violence shelter or service must
3 agree to enroll all of its employees and pay the entire cost
4 of providing such coverage for its employees. A
5 participating domestic violence shelter may also elect to
6 cover its annuitants. Dependent coverage shall be offered on
7 an optional basis, with employees, or some combination of the
8 2 as determined by the domestic violence shelter or service.
9 The domestic violence shelter or service shall be responsible
10 for timely collection and transmission of dependent premiums.
11 The Director shall annually determine quarterly rates of
12 payment, subject to the following constraints:
13 (1) In the first year of coverage, the rates shall
14 be equal to the amount normally charged to State
15 employees for elected optional coverages or for enrolled
16 dependents coverages or other contributory coverages on
17 behalf of its employees, adjusted for differences between
18 State employees and employees of the domestic violence
19 shelter or service in age, sex, geographic location or
20 other relevant demographic variables, plus an amount
21 sufficient to pay for the additional administrative costs
22 of providing coverage to employees of the domestic
23 violence shelter or service and their dependents.
24 (2) In subsequent years, a further adjustment shall
25 be made to reflect the actual prior years' claims
26 experience of the employees of the domestic violence
27 shelter or service.
28 (3) In no case shall the rate be less than the
29 amount normally charged to State employees or contributed
30 by the State on behalf of its employees.
31 Monthly payments by the domestic violence shelter or
32 service or its employees for group health insurance shall be
33 deposited in the Local Government Health Insurance Reserve
34 Fund.
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1 (l) A public community college or entity organized
2 pursuant to the Public Community College Act may apply to the
3 Director initially to have only annuitants not covered prior
4 to July 1, 1992 by the district's health plan provided health
5 coverage under this Act on a non-insured basis. The
6 community college must execute a 2-year contract to
7 participate in the Local Government Health Plan. Those
8 annuitants enrolled initially under this contract shall have
9 no benefits payable for services incurred during the first 6
10 months of coverage to the extent the services are in
11 connection with any pre-existing condition. Any annuitant
12 who may enroll after this initial enrollment period shall be
13 subject to submission of satisfactory evidence of
14 insurability and to the pre-existing conditions limitation.
15 The Director shall annually determine monthly rates of
16 payment subject to the following constraints: for those
17 community colleges with annuitants only enrolled, first year
18 rates shall be equal to the average cost to cover claims for
19 a State member adjusted for demographics, Medicare
20 participation, and other factors; and in the second year, a
21 further adjustment of rates shall be made to reflect the
22 actual first year's claims experience of the covered
23 annuitants.
24 (m) The Director shall adopt any rules deemed necessary
25 for implementation of this amendatory Act of 1989 (Public Act
26 86-978).
27 (Source: P.A. 89-53, eff. 7-1-95; 89-236, eff. 8-4-95;
28 89-324, eff. 8-13-95; 89-626, eff. 8-9-96; 90-65, eff.
29 7-7-97; 90-582, eff. 5-27-98; 90-655, eff. 7-30-98; revised
30 8-3-98.)
31 Section 10. The Illinois Pension Code is amended by
32 adding Section 15-135.1 as follows:
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1 (40 ILCS 5/15-135.1 new)
2 Sec. 15-135.1. Election to avoid application of P.A.
3 90-65.
4 (a) A participant who was an employee on July 7, 1997
5 and retires on or after the effective date of this amendatory
6 Act of 1998 may elect in writing at the time of retirement to
7 have the retirement annuity calculated in accordance with the
8 provisions of Sections 15-135 and 15-136 as they existed
9 immediately prior to amendment by Public Act 90-65. This
10 election, once made, is irrevocable.
11 (b) The fact that a person has elected to participate in
12 the optional retirement program under Section 15-158.2 or has
13 elected the portability option under subsection (a-1) of
14 Section 15-154 does not prevent the person from making an
15 election under subsection (a) of this Section; the fact that
16 such a person makes an election under subsection (a) does not
17 allow the person to change the irrevocable election that he
18 or she made under Section 15-158.2 or subsection (a-1) of
19 Section 15-154.
20 (c) The System shall promptly notify the Department of
21 Central Management Services of each election made under this
22 Section.
23 Section 99. Effective date. This Act takes effect upon
24 becoming law.".