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92_HB0181enr HB0181 Enrolled LRB9202031JSpc 1 AN ACT concerning government employee benefits. 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 5 1971 is amended by changing Section 3 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 11 of implementing specific programs providing benefits under 12 this 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 16 capable 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 19 has retired, on or after January 1, 1966 on an immediate 20 annuity under the provisions of Articles 2, 14, 15 (including 21 an employee who has retired under the optional retirement 22 program established under Section 15-158.2), paragraphs (2), 23 (3), or (5) of Section 16-106, or Article 18 of the Illinois 24 Pension Code; (2) any person who was receiving group 25 insurance coverage under this Act as of March 31, 1978 by 26 reason of his status as an annuitant, even though the annuity 27 in relation to which such coverage was provided is a 28 proportional annuity based on less than the minimum period of 29 service required for a retirement annuity in the system 30 involved; (3) any person not otherwise covered by this Act 31 who has retired as a participating member under Article 2 of HB0181 Enrolled -2- LRB9202031JSpc 1 the Illinois Pension Code but is ineligible for the 2 retirement annuity under Section 2-119 of the Illinois 3 Pension Code; (4) the spouse of any person who is receiving a 4 retirement annuity under Article 18 of the Illinois Pension 5 Code and who is covered under a group health insurance 6 program sponsored by a governmental employer other than the 7 State of Illinois and who has irrevocably elected to waive 8 his or her coverage under this Act and to have his or her 9 spouse considered as the "annuitant" under this Act and not 10 as a "dependent"; or (5) an employee who retires, or has 11 retired, from a qualified position, as determined according 12 to rules promulgated by the Director, under a qualified local 13 government or a qualified rehabilitation facility or a 14 qualified domestic violence shelter or service. (For 15 definition of "retired employee", see (p) post). 16 (b-5) "New SERS annuitant" means a person who, on or 17 after January 1, 1998, becomes an annuitant, as defined in 18 subsection (b), by virtue of beginning to receive a 19 retirement annuity under Article 14 of the Illinois Pension 20 Code, and is eligible to participate in the basic program of 21 group health benefits provided for annuitants under this Act. 22 (b-6) "New SURS annuitant" means a person who (1) on or 23 after January 1, 1998, becomes an annuitant, as defined in 24 subsection (b), by virtue of beginning to receive a 25 retirement annuity under Article 15 of the Illinois Pension 26 Code, (2) has not made the election authorized under Section 27 15-135.1 of the Illinois Pension Code, and (3) is eligible to 28 participate in the basic program of group health benefits 29 provided for annuitants under this Act. 30 (b-7) "New TRS State annuitant" means a person who, on 31 or after July 1, 1998, becomes an annuitant, as defined in 32 subsection (b), by virtue of beginning to receive a 33 retirement annuity under Article 16 of the Illinois Pension 34 Code based on service as a teacher as defined in paragraph HB0181 Enrolled -3- LRB9202031JSpc 1 (2), (3), or (5) of Section 16-106 of that Code, and is 2 eligible to participate in the basic program of group health 3 benefits provided for annuitants under this Act. 4 (c) "Carrier" means (1) an insurance company, a 5 corporation organized under the Limited Health Service 6 Organization Act or the Voluntary Health Services Plan Act, a 7 partnership, or other nongovernmental organization, which is 8 authorized to do group life or group health insurance 9 business in Illinois, or (2) the State of Illinois as a 10 self-insurer. 11 (d) "Compensation" means salary or wages payable on a 12 regular payroll by the State Treasurer on a warrant of the 13 State Comptroller out of any State, trust or federal fund, or 14 by the Governor of the State through a disbursing officer of 15 the State out of a trust or out of federal funds, or by any 16 Department out of State, trust, federal or other funds held 17 by the State Treasurer or the Department, to any person for 18 personal services currently performed, and ordinary or 19 accidental disability benefits under Articles 2, 14, 15 20 (including ordinary or accidental disability benefits under 21 the optional retirement program established under Section 22 15-158.2), paragraphs (2), (3), or (5) of Section 16-106, or 23 Article 18 of the Illinois Pension Code, for disability 24 incurred after January 1, 1966, or benefits payable under the 25 Workers' Compensation or Occupational Diseases Act or 26 benefits payable under a sick pay plan established in 27 accordance with Section 36 of the State Finance Act. 28 "Compensation" also means salary or wages paid to an employee 29 of any qualified local government or qualified rehabilitation 30 facility or a qualified domestic violence shelter or service. 31 (e) "Commission" means the State Employees Group 32 Insurance Advisory Commission authorized by this Act. 33 Commencing July 1, 1984, "Commission" as used in this Act 34 means the Illinois Economic and Fiscal Commission as HB0181 Enrolled -4- LRB9202031JSpc 1 established by the Legislative Commission Reorganization Act 2 of 1984. 3 (f) "Contributory", when referred to as contributory 4 coverage, shall mean optional coverages or benefits elected 5 by the member toward the cost of which such member makes 6 contribution, or which are funded in whole or in part through 7 the acceptance of a reduction in earnings or the foregoing of 8 an increase in earnings by an employee, as distinguished from 9 noncontributory coverage or benefits which are paid entirely 10 by the State of Illinois without reduction of the member's 11 salary. 12 (g) "Department" means any department, institution, 13 board, commission, officer, court or any agency of the State 14 government receiving appropriations and having power to 15 certify payrolls to the Comptroller authorizing payments of 16 salary and wages against such appropriations as are made by 17 the General Assembly from any State fund, or against trust 18 funds held by the State Treasurer and includes boards of 19 trustees of the retirement systems created by Articles 2, 14, 20 15, 16 and 18 of the Illinois Pension Code. "Department" 21 also includes the Illinois Comprehensive Health Insurance 22 Board, the Board of Examiners established under the Illinois 23 Public Accounting Act, and the Illinois Rural Bond Bank. 24 (h) "Dependent", when the term is used in the context of 25 the health and life plan, means a member's spouse and any 26 unmarried child (1) from birth to age 19 including an adopted 27 child, a child who lives with the member from the time of the 28 filing of a petition for adoption until entry of an order of 29 adoption, a stepchild or recognized child who lives with the 30 member in a parent-child relationship, or a child who lives 31 with the member if such member is a court appointed guardian 32 of the child, or (2) age 19 to 23 enrolled as a full-time 33 student in any accredited school, financially dependent upon 34 the member, and eligible to be claimed as a dependent for HB0181 Enrolled -5- LRB9202031JSpc 1 income tax purposes, or (3) age 19 or over who is mentally or 2 physically handicapped. For the health plan only, the term 3 "dependent" also includes any person enrolled prior to the 4 effective date of this Section who is dependent upon the 5 member to the extent that the member may claim such person as 6 a dependent for income tax deduction purposes; no other such 7 person may be enrolled. 8 (i) "Director" means the Director of the Illinois 9 Department of Central Management Services. 10 (j) "Eligibility period" means the period of time a 11 member has to elect enrollment in programs or to select 12 benefits without regard to age, sex or health. 13 (k) "Employee" means and includes each officer or 14 employee in the service of a department who (1) receives his 15 compensation for service rendered to the department on a 16 warrant issued pursuant to a payroll certified by a 17 department or on a warrant or check issued and drawn by a 18 department upon a trust, federal or other fund or on a 19 warrant issued pursuant to a payroll certified by an elected 20 or duly appointed officer of the State or who receives 21 payment of the performance of personal services on a warrant 22 issued pursuant to a payroll certified by a Department and 23 drawn by the Comptroller upon the State Treasurer against 24 appropriations made by the General Assembly from any fund or 25 against trust funds held by the State Treasurer, and (2) is 26 employed full-time or part-time in a position normally 27 requiring actual performance of duty during not less than 1/2 28 of a normal work period, as established by the Director in 29 cooperation with each department, except that persons elected 30 by popular vote will be considered employees during the 31 entire term for which they are elected regardless of hours 32 devoted to the service of the State, and (3) except that 33 "employee" does not include any person who is not eligible by 34 reason of such person's employment to participate in one of HB0181 Enrolled -6- LRB9202031JSpc 1 the State retirement systems under Articles 2, 14, 15 (either 2 the regular Article 15 system or the optional retirement 3 program established under Section 15-158.2) or 18, or under 4 paragraph (2), (3), or (5) of Section 16-106, of the Illinois 5 Pension Code, but such term does include persons who are 6 employed during the 6 month qualifying period under Article 7 14 of the Illinois Pension Code. Such term also includes any 8 person who (1) after January 1, 1966, is receiving ordinary 9 or accidental disability benefits under Articles 2, 14, 15 10 (including ordinary or accidental disability benefits under 11 the optional retirement program established under Section 12 15-158.2), paragraphs (2), (3), or (5) of Section 16-106, or 13 Article 18 of the Illinois Pension Code, for disability 14 incurred after January 1, 1966, (2) receives total permanent 15 or total temporary disability under the Workers' Compensation 16 Act or Occupational Disease Act as a result of injuries 17 sustained or illness contracted in the course of employment 18 with the State of Illinois, or (3) is not otherwise covered 19 under this Act and has retired as a participating member 20 under Article 2 of the Illinois Pension Code but is 21 ineligible for the retirement annuity under Section 2-119 of 22 the Illinois Pension Code. However, a person who satisfies 23 the criteria of the foregoing definition of "employee" except 24 that such person is made ineligible to participate in the 25 State Universities Retirement System by clause (4) of 26 subsection (a) of Section 15-107 of the Illinois Pension Code 27 is also an "employee" for the purposes of this Act. 28 "Employee" also includes any person receiving or eligible for 29 benefits under a sick pay plan established in accordance with 30 Section 36 of the State Finance Act. "Employee" also includes 31 each officer or employee in the service of a qualified local 32 government, including persons appointed as trustees of 33 sanitary districts regardless of hours devoted to the service 34 of the sanitary district, and each employee in the service of HB0181 Enrolled -7- LRB9202031JSpc 1 a qualified rehabilitation facility and each full-time 2 employee in the service of a qualified domestic violence 3 shelter or service, as determined according to rules 4 promulgated by the Director. 5 (l) "Member" means an employee, annuitant, retired 6 employee or survivor. 7 (m) "Optional coverages or benefits" means those 8 coverages or benefits available to the member on his or her 9 voluntary election, and at his or her own expense. 10 (n) "Program" means the group life insurance, health 11 benefits and other employee benefits designed and contracted 12 for by the Director under this Act. 13 (o) "Health plan" means a health benefits program 14 offered by the State of Illinois for persons eligible for the 15 plan. 16 (p) "Retired employee" means any person who would be an 17 annuitant as that term is defined herein but for the fact 18 that such person retired prior to January 1, 1966. Such term 19 also includes any person formerly employed by the University 20 of Illinois in the Cooperative Extension Service who would be 21 an annuitant but for the fact that such person was made 22 ineligible to participate in the State Universities 23 Retirement System by clause (4) of subsection (a) of Section 24 15-107 of the Illinois Pension Code. 25 (q) "Survivor" means a person receiving an annuity as a 26 survivor of an employee or of an annuitant. "Survivor" also 27 includes: (1) the surviving dependent of a person who 28 satisfies the definition of "employee" except that such 29 person is made ineligible to participate in the State 30 Universities Retirement System by clause (4) of subsection 31 (a) of Section 15-107 of the Illinois Pension Code; and (2) 32 the surviving dependent of any person formerly employed by 33 the University of Illinois in the Cooperative Extension 34 Service who would be an annuitant except for the fact that HB0181 Enrolled -8- LRB9202031JSpc 1 such person was made ineligible to participate in the State 2 Universities Retirement System by clause (4) of subsection 3 (a) of Section 15-107 of the Illinois Pension Code. 4 (q-5) "New SERS survivor" means a survivor, as defined 5 in subsection (q), whose annuity is paid under Article 14 of 6 the Illinois Pension Code and is based on the death of (i) an 7 employee whose death occurs on or after January 1, 1998, or 8 (ii) a new SERS annuitant as defined in subsection (b-5). 9 (q-6) "New SURS survivor" means a survivor, as defined 10 in subsection (q), whose annuity is paid under Article 15 of 11 the Illinois Pension Code and is based on the death of (i) an 12 employee whose death occurs on or after January 1, 1998, or 13 (ii) a new SURS annuitant as defined in subsection (b-6). 14 (q-7) "New TRS State survivor" means a survivor, as 15 defined in subsection (q), whose annuity is paid under 16 Article 16 of the Illinois Pension Code and is based on the 17 death of (i) an employee who is a teacher as defined in 18 paragraph (2), (3), or (5) of Section 16-106 of that Code and 19 whose death occurs on or after July 1, 1998, or (ii) a new 20 TRS State annuitant as defined in subsection (b-7). 21 (r) "Medical services" means the services provided 22 within the scope of their licenses by practitioners in all 23 categories licensed under the Medical Practice Act of 1987. 24 (s) "Unit of local government" means any county, 25 municipality, township, school district (including a 26 combination of school districts under the Intergovernmental 27 Cooperation Act), special district or other unit, designated 28 as a unit of local government by law, which exercises limited 29 governmental powers or powers in respect to limited 30 governmental subjects, any not-for-profit association with a 31 membership that primarily includes townships and township 32 officials, that has duties that include provision of research 33 service, dissemination of information, and other acts for the 34 purpose of improving township government, and that is funded HB0181 Enrolled -9- LRB9202031JSpc 1 wholly or partly in accordance with Section 85-15 of the 2 Township Code; any not-for-profit corporation or association, 3 with a membership consisting primarily of municipalities, 4 that operates its own utility system, and provides research, 5 training, dissemination of information, or other acts to 6 promote cooperation between and among municipalities that 7 provide utility services and for the advancement of the goals 8 and purposes of its membership; the Southern Illinois 9 Collegiate Common Market, which is a consortium of higher 10 education institutions in Southern Illinois; and the Illinois 11 Association of Park Districts. "Qualified local government" 12 means a unit of local government approved by the Director and 13 participating in a program created under subsection (i) of 14 Section 10 of this Act. 15 (t) "Qualified rehabilitation facility" means any 16 not-for-profit organization that is accredited by the 17 Commission on Accreditation of Rehabilitation Facilities or 18 certified by the Department of Human Services (as successor 19 to the Department of Mental Health and Developmental 20 Disabilities) to provide services to persons with 21 disabilities and which receives funds from the State of 22 Illinois for providing those services, approved by the 23 Director and participating in a program created under 24 subsection (j) of Section 10 of this Act. 25 (u) "Qualified domestic violence shelter or service" 26 means any Illinois domestic violence shelter or service and 27 its administrative offices funded by the Department of Human 28 Services (as successor to the Illinois Department of Public 29 Aid), approved by the Director and participating in a program 30 created under subsection (k) of Section 10. 31 (v) "TRS benefit recipient" means a person who: 32 (1) is not a "member" as defined in this Section; 33 and 34 (2) is receiving a monthly benefit or retirement HB0181 Enrolled -10- LRB9202031JSpc 1 annuity under Article 16 of the Illinois Pension Code; 2 and 3 (3) either (i) has at least 8 years of creditable 4 service under Article 16 of the Illinois Pension Code, or 5 (ii) was enrolled in the health insurance program offered 6 under that Article on January 1, 1996, or (iii) is the 7 survivor of a benefit recipient who had at least 8 years 8 of creditable service under Article 16 of the Illinois 9 Pension Code or was enrolled in the health insurance 10 program offered under that Article on the effective date 11 of this amendatory Act of 1995, or (iv) is a recipient or 12 survivor of a recipient of a disability benefit under 13 Article 16 of the Illinois Pension Code. 14 (w) "TRS dependent beneficiary" means a person who: 15 (1) is not a "member" or "dependent" as defined in 16 this Section; and 17 (2) is a TRS benefit recipient's: (A) spouse, (B) 18 dependent parent who is receiving at least half of his or 19 her support from the TRS benefit recipient, or (C) 20 unmarried natural or adopted child who is (i) under age 21 19, or (ii) enrolled as a full-time student in an 22 accredited school, financially dependent upon the TRS 23 benefit recipient, eligible to be claimed as a dependent 24 for income tax purposes, and either is under age 24 or 25 was, on January 1, 1996, participating as a dependent 26 beneficiary in the health insurance program offered under 27 Article 16 of the Illinois Pension Code, or (iii) age 19 28 or over who is mentally or physically handicapped. 29 (x) "Military leave with pay and benefits" refers to 30 individuals in basic training for reserves, special/advanced 31 training, annual training, emergency call up, or activation 32 by the President of the United States with approved pay and 33 benefits. 34 (y) "Military leave without pay and benefits" refers to HB0181 Enrolled -11- LRB9202031JSpc 1 individuals who enlist for active duty in a regular component 2 of the U.S. Armed Forces or other duty not specified or 3 authorized under military leave with pay and benefits. 4 (z) "Community college benefit recipient" means a person 5 who: 6 (1) is not a "member" as defined in this Section; 7 and 8 (2) is receiving a monthly survivor's annuity or 9 retirement annuity under Article 15 of the Illinois 10 Pension Code; and 11 (3) either (i) was a full-time employee of a 12 community college district or an association of community 13 college boards created under the Public Community College 14 Act (other than an employee whose last employer under 15 Article 15 of the Illinois Pension Code was a community 16 college district subject to Article VII of the Public 17 Community College Act) and was eligible to participate in 18 a group health benefit plan as an employee during the 19 time of employment with a community college district 20 (other than a community college district subject to 21 Article VII of the Public Community College Act) or an 22 association of community college boards, or (ii) is the 23 survivor of a person described in item (i). 24 (aa) "Community college dependent beneficiary" means a 25 person who: 26 (1) is not a "member" or "dependent" as defined in 27 this Section; and 28 (2) is a community college benefit recipient's: (A) 29 spouse, (B) dependent parent who is receiving at least 30 half of his or her support from the community college 31 benefit recipient, or (C) unmarried natural or adopted 32 child who is (i) under age 19, or (ii) enrolled as a 33 full-time student in an accredited school, financially 34 dependent upon the community college benefit recipient, HB0181 Enrolled -12- LRB9202031JSpc 1 eligible to be claimed as a dependent for income tax 2 purposes and under age 23, or (iii) age 19 or over and 3 mentally or physically handicapped. 4 (Source: P.A. 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; 91-390, eff. 7 7-30-99; 91-395, eff. 7-30-99; 91-617, eff, 8-19-99; revised 8 10-19-99.)