Public Act 102-0019
 
HB0706 EnrolledLRB102 11853 RJF 17189 b

    AN ACT concerning government.
 
    Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
 
    Section 5. The State Employees Group Insurance Act of 1971
is amended by changing Sections 2, 6.1, 6.2, 7, 8, 10, 13, and
13.1 as follows:
 
    (5 ILCS 375/2)  (from Ch. 127, par. 522)
    Sec. 2. Purpose. The purpose of this Act is to provide a
program of group life insurance, a program of health benefits
and other employee benefits for persons in the service of the
State of Illinois, employees of local governments, employees
of rehabilitation facilities, employees of domestic violence
shelters and services, and employees of child advocacy
centers, and certain of their dependents. It is also the
purpose of this Act to provide a program of health benefits (i)
for certain benefit recipients of the Teachers' Retirement
System of the State of Illinois and their dependent
beneficiaries, and (ii) for certain eligible retired community
college employees and their dependent beneficiaries, and (iii)
for employees of local governments, employees of
rehabilitation facilities, employees of domestic violence
shelters and services, and employees of child advocacy
centers, and certain of their dependents.
(Source: P.A. 94-860, eff. 6-16-06.)
 
    (5 ILCS 375/6.1)  (from Ch. 127, par. 526.1)
    Sec. 6.1. The program of health benefits may offer as an
alternative, available on an optional basis, coverage through
health maintenance organizations or other managed care
programs. That part of the premium for such coverage which is
in excess of the amount which would otherwise be paid by the
State for the program of health benefits shall be paid by the
member who elects such alternative coverage and shall be
collected as provided for premiums for other optional
coverages.
(Source: P.A. 100-538, eff. 1-1-18.)
 
    (5 ILCS 375/6.2)  (from Ch. 127, par. 526.2)
    Sec. 6.2. When the Director, with the advice and consent
of the Commission, determines that it would be in the best
interests of the State and its employees, any the program of
health benefits under this Act may be administered with the
State as a self-insurer in whole or in part. The State assumes
the risks of any such the program. The State may provide the
administrative services in connection with any the
self-insurance health plan or purchase administrative services
from an administrative service organization. A plan of
self-insurance may combine forms of re-insurance or stop-loss
insurance which limits the amount of State liability.
    The program of health benefits shall provide a
continuation and conversion privilege for persons whose State
employment is terminated and a continuation privilege for
members' spouses and dependent children who are covered under
the provisions of the program, consistent with the
requirements of federal law and Sections 367.2, 367e, and
367e.1 of the Illinois Insurance Code.
(Source: P.A. 93-477, eff. 1-1-04.)
 
    (5 ILCS 375/7)  (from Ch. 127, par. 527)
    Sec. 7. Group life insurance program.
    (a) The basic noncontributory group life insurance program
shall provide coverage as follows:
        (1) employees shall be insured in an amount equal to
    the basic annual salary rate, exclusive of overtime,
    bonus, or other cumulative additional income factors,
    raised to the next round hundred dollar amount if it is not
    already a round hundred dollar amount;
        (2) annuitants shall be insured in the same manner as
    described for active employees, based on the salary in
    force immediately before retirement, with coverage
    becoming effective on the effective date of retirement
    benefits or the first day of the month of application,
    whichever occurs later, except that at age 60 the amount
    of coverage for the annuitant shall be reduced to $5,000;
        (3) survivors whose coverage became effective prior to
    September 22, 1979 shall be insured for $2,000;
        (4) retired employees shall not be eligible under the
    group life insurance program contracted to begin or
    continue after June 30, 1973.
    (a-5) There shall also be available on an optional basis
to employees, annuitants whose retirement benefits begin
within one year of their receipt of final compensation, and
survivors whose coverage became effective prior to September
22, 1979, a contributory program of:
        (1) supplemental life insurance in an amount not
    exceeding 8 times the basic life benefits for active
    employees and annuitants under age 60 and not exceeding 4
    times the basic life benefits for annuitants age 60 and
    over, as described above, except that (a) amounts selected
    by employees and annuitants must be in full multiples of
    the basic amount, and (b) premiums may be adjusted by age
    bracket established in rules supplementing this Act;
    beginning July 1, 1981, survivors whose coverage becomes
    effective on or after September 22, 1979, shall have the
    option of participating in the contributory program of
    life insurance in an amount of $5,000 coverage;
        (2) accidental death and dismemberment, with the
    employee and annuitant having the option of electing an
    amount equal to the basic noncontributory life benefits
    only, or an amount equaling the combined total of basic
    plus optional life benefits not exceeding 5 times basic
    life benefits, or $3,000,000, whichever is less;
        (3) dependent life insurance in an amount of $10,000
    coverage on the spouse; however, coverage reduces to
    $5,000 when the eligible spouse annuitant turns 60; and
        (4) dependent life insurance in an amount of $10,000
    coverage on each dependent other than the spouse.
    (b) A member, not otherwise covered by this Act, who has
retired as a participating member under Article 2 of the
Illinois Pension Code, but is ineligible for the retirement
annuity under Section 2-119 of the Illinois Pension Code,
shall pay the premiums for coverage under the group life
insurance program under this Act. The Director shall
promulgate rules and regulations to determine the premiums to
be paid by a member under this subsection (b).
(Source: P.A. 94-95, eff. 7-1-05.)
 
    (5 ILCS 375/8)  (from Ch. 127, par. 528)
    Sec. 8. Eligibility.
    (a) Each employee eligible under the provisions of this
Act and any rules and regulations promulgated and adopted
hereunder by the Director shall become immediately eligible
and covered for all benefits available under the programs.
Employees electing coverage for eligible dependents shall have
the coverage effective immediately, provided that the election
is properly filed in accordance with required filing dates and
procedures specified by the Director, including the completion
and submission of all documentation and forms required by the
Director.
        (1) Every member originally eligible to elect
    dependent coverage, but not electing it during the
    original eligibility period, may subsequently obtain
    dependent coverage only in the event of a qualifying
    change in status, special enrollment, special circumstance
    as defined by the Director, or during the annual Benefit
    Choice Period.
        (2) Members described above being transferred from
    previous coverage towards which the State has been
    contributing shall be transferred regardless of
    preexisting conditions, waiting periods, or other
    requirements that might jeopardize claim payments to which
    they would otherwise have been entitled.
        (3) Eligible and covered members that are eligible for
    coverage as dependents except for the fact of being
    members shall be transferred to, and covered under,
    dependent status regardless of preexisting conditions,
    waiting periods, or other requirements that might
    jeopardize claim payments to which they would otherwise
    have been entitled upon cessation of member status and the
    election of dependent coverage by a member eligible to
    elect that coverage.
    (b) New employees shall be immediately insured for the
basic group life insurance and covered by the program of
health benefits on the first day of active State service.
Optional life insurance coverage one to 4 times the basic
amount, if elected during the relevant eligibility period,
will become effective on the date of employment. Optional life
insurance coverage exceeding 4 times the basic amount and all
life insurance amounts applied for after the eligibility
period will be effective, subject to satisfactory evidence of
insurability when applicable, or other necessary
qualifications, pursuant to the requirements of the applicable
benefit program, unless there is a change in status that would
confer new eligibility for change of enrollment under rules
established supplementing this Act, in which event application
must be made within the new eligibility period.
    (c) As to the group health benefits program contracted to
begin or continue after June 30, 1973, each annuitant,
survivor, and retired employee shall become immediately
eligible for all benefits available under that program. Each
annuitant, survivor, and retired employee shall have coverage
effective immediately, provided that the election is properly
filed in accordance with the required filing dates and
procedures specified by the Director, including the completion
and submission of all documentation and forms required by the
Director. Annuitants, survivors, and retired employees may
elect coverage for eligible dependents and shall have the
coverage effective immediately, provided that the election is
properly filed in accordance with required filing dates and
procedures specified by the Director, except that, for a
survivor, the dependent sought to be added on or after the
effective date of this amendatory Act of the 97th General
Assembly must have been eligible for coverage as a dependent
under the deceased member upon whom the survivor's annuity is
based in order to be eligible for coverage under the survivor.
    Except as otherwise provided in this Act, where husband
and wife are both eligible members, each shall be enrolled as a
member and coverage on their eligible dependent children, if
any, may be under the enrollment and election of either.
    Regardless of other provisions herein regarding late
enrollment or other qualifications, as appropriate, the
Director may periodically authorize open enrollment periods
for each of the benefit programs at which time each member may
elect enrollment or change of enrollment without regard to
age, sex, health, or other qualification under the conditions
as may be prescribed in rules and regulations supplementing
this Act. Special open enrollment periods may be declared by
the Director for certain members only when special
circumstances occur that affect only those members.
    (d) Eligible Beginning with fiscal year 2003 and for all
subsequent years, eligible members may elect not to
participate in the program of health benefits as defined in
this Act. The election must be made during the annual benefit
choice period or upon showing a qualifying change in status as
defined in the U.S. Internal Revenue Code, subject to the
conditions in this subsection.
        (1) (Blank). Members must furnish proof of health
    benefit coverage, either comprehensive major medical
    coverage or comprehensive managed care plan, from a source
    other than the Department of Central Management Services
    in order to elect not to participate in the program.
        (2) Members may re-enroll in the Department of Central
    Management Services program of health benefits upon
    showing a qualifying change in status, as defined in the
    U.S. Internal Revenue Code, without evidence of
    insurability and with no limitations on coverage for
    pre-existing conditions, provided that there was not a
    break in coverage of more than 63 days.
        (3) Members may also re-enroll in the program of
    health benefits during any annual benefit choice period,
    without evidence of insurability.
        (4) Members who elect not to participate in the
    program of health benefits shall be furnished a written
    explanation of the requirements and limitations for the
    election not to participate in the program and for
    re-enrolling in the program. The explanation shall also be
    included in the annual benefit choice options booklets
    furnished to members.
    (d-5) Beginning July 1, 2005, the Director may establish a
program of financial incentives to encourage annuitants
receiving a retirement annuity, but who are not eligible for
benefits under the federal Medicare health insurance program
(Title XVIII of the Social Security Act, as added by Public Law
89-97) to elect not to participate in the program of health
benefits provided under this Act. The election by an annuitant
not to participate under this program must be made in
accordance with the requirements set forth under subsection
(d). The financial incentives provided to these annuitants
under the program may not exceed $150 per month for each
annuitant electing not to participate in the program of health
benefits provided under this Act.
    (d-6) Beginning July 1, 2013, the Director may establish a
program of financial incentives to encourage annuitants with
20 or more years of creditable service but who are not eligible
for benefits under the federal Medicare health insurance
program (Title XVIII of the Social Security Act, as added by
Public Law 89-97) to elect not to participate in the program of
health benefits provided under this Act. The election by an
annuitant not to participate under this program must be made
in accordance with the requirements set forth under subsection
(d). The program established under this subsection (d-6) may
include a prorated incentive for annuitants with fewer than 20
years of creditable service, as determined by the Director.
The financial incentives provided to these annuitants under
this program may not exceed $500 per month for each annuitant
electing not to participate in the program of health benefits
provided under this Act.
    (e) Notwithstanding any other provision of this Act or the
rules adopted under this Act, if a person participating in the
program of health benefits as the dependent spouse of an
eligible member becomes an annuitant, the person may elect, at
the time of becoming an annuitant or during any subsequent
annual benefit choice period, to continue participation as a
dependent rather than as an eligible member for as long as the
person continues to be an eligible dependent. In order to be
eligible to make such an election, the person must have been
enrolled as a dependent under the program of health benefits
for no less than one year prior to becoming an annuitant.
    An eligible member who has elected to participate as a
dependent may re-enroll in the program of health benefits as
an eligible member (i) during any subsequent annual benefit
choice period or (ii) upon showing a qualifying change in
status, as defined in the U.S. Internal Revenue Code, without
evidence of insurability and with no limitations on coverage
for pre-existing conditions.
    A person who elects to participate in the program of
health benefits as a dependent rather than as an eligible
member shall be furnished a written explanation of the
consequences of electing to participate as a dependent and the
conditions and procedures for re-enrolling as an eligible
member. The explanation shall also be included in the annual
benefit choice options booklet furnished to members.
(Source: P.A. 97-668, eff. 1-13-12; 98-19, eff. 6-10-13.)
 
    (5 ILCS 375/10)  (from Ch. 127, par. 530)
    Sec. 10. Contributions by the State and members.
    (a) The State shall pay the cost of basic non-contributory
group life insurance and, subject to member paid contributions
set by the Department or required by this Section and except as
provided in this Section, the basic program of group health
benefits on each eligible member, except a member, not
otherwise covered by this Act, who has retired as a
participating member under Article 2 of the Illinois Pension
Code but is ineligible for the retirement annuity under
Section 2-119 of the Illinois Pension Code, and part of each
eligible member's and retired member's premiums for health
insurance coverage for enrolled dependents as provided by
Section 9. The State shall pay the cost of the basic program of
group health benefits only after benefits are reduced by the
amount of benefits covered by Medicare for all members and
dependents who are eligible for benefits under Social Security
or the Railroad Retirement system or who had sufficient
Medicare-covered government employment, except that such
reduction in benefits shall apply only to those members and
dependents who (1) first become eligible for such Medicare
coverage on or after July 1, 1992; or (2) are
Medicare-eligible members or dependents of a local government
unit which began participation in the program on or after July
1, 1992; or (3) remain eligible for, but no longer receive
Medicare coverage which they had been receiving on or after
July 1, 1992. The Department may determine the aggregate level
of the State's contribution on the basis of actual cost of
medical services adjusted for age, sex or geographic or other
demographic characteristics which affect the costs of such
programs.
    The cost of participation in the basic program of group
health benefits for the dependent or survivor of a living or
deceased retired employee who was formerly employed by the
University of Illinois in the Cooperative Extension Service
and would be an annuitant but for the fact that he or she was
made ineligible to participate in the State Universities
Retirement System by clause (4) of subsection (a) of Section
15-107 of the Illinois Pension Code shall not be greater than
the cost of participation that would otherwise apply to that
dependent or survivor if he or she were the dependent or
survivor of an annuitant under the State Universities
Retirement System.
    (a-1) (Blank).
    (a-2) (Blank).
    (a-3) (Blank).
    (a-4) (Blank).
    (a-5) (Blank).
    (a-6) (Blank).
    (a-7) (Blank).
    (a-8) Any annuitant, survivor, or retired employee may
waive or terminate coverage in the program of group health
benefits. Any such annuitant, survivor, or retired employee
who has waived or terminated coverage may enroll or re-enroll
in the program of group health benefits only during the annual
benefit choice period, as determined by the Director; except
that in the event of termination of coverage due to nonpayment
of premiums, the annuitant, survivor, or retired employee may
not re-enroll in the program.
    (a-8.5) Beginning on the effective date of this amendatory
Act of the 97th General Assembly, the Director of Central
Management Services shall, on an annual basis, determine the
amount that the State shall contribute toward the basic
program of group health benefits on behalf of annuitants
(including individuals who (i) participated in the General
Assembly Retirement System, the State Employees' Retirement
System of Illinois, the State Universities Retirement System,
the Teachers' Retirement System of the State of Illinois, or
the Judges Retirement System of Illinois and (ii) qualify as
annuitants under subsection (b) of Section 3 of this Act),
survivors (including individuals who (i) receive an annuity as
a survivor of an individual who participated in the General
Assembly Retirement System, the State Employees' Retirement
System of Illinois, the State Universities Retirement System,
the Teachers' Retirement System of the State of Illinois, or
the Judges Retirement System of Illinois and (ii) qualify as
survivors under subsection (q) of Section 3 of this Act), and
retired employees (as defined in subsection (p) of Section 3
of this Act). The remainder of the cost of coverage for each
annuitant, survivor, or retired employee, as determined by the
Director of Central Management Services, shall be the
responsibility of that annuitant, survivor, or retired
employee.
    Contributions required of annuitants, survivors, and
retired employees shall be the same for all retirement systems
and shall also be based on whether an individual has made an
election under Section 15-135.1 of the Illinois Pension Code.
Contributions may be based on annuitants', survivors', or
retired employees' Medicare eligibility, but may not be based
on Social Security eligibility.
    (a-9) No later than May 1 of each calendar year, the
Director of Central Management Services shall certify in
writing to the Executive Secretary of the State Employees'
Retirement System of Illinois the amounts of the Medicare
supplement health care premiums and the amounts of the health
care premiums for all other retirees who are not Medicare
eligible.
    A separate calculation of the premiums based upon the
actual cost of each health care plan shall be so certified.
    The Director of Central Management Services shall provide
to the Executive Secretary of the State Employees' Retirement
System of Illinois such information, statistics, and other
data as he or she may require to review the premium amounts
certified by the Director of Central Management Services.
    The Department of Central Management Services, or any
successor agency designated to procure healthcare contracts
pursuant to this Act, is authorized to establish funds,
separate accounts provided by any bank or banks as defined by
the Illinois Banking Act, or separate accounts provided by any
savings and loan association or associations as defined by the
Illinois Savings and Loan Act of 1985 to be held by the
Director, outside the State treasury, for the purpose of
receiving the transfer of moneys from the Local Government
Health Insurance Reserve Fund. The Department may promulgate
rules further defining the methodology for the transfers. Any
interest earned by moneys in the funds or accounts shall inure
to the Local Government Health Insurance Reserve Fund. The
transferred moneys, and interest accrued thereon, shall be
used exclusively for transfers to administrative service
organizations or their financial institutions for payments of
claims to claimants and providers under the self-insurance
health plan. The transferred moneys, and interest accrued
thereon, shall not be used for any other purpose including,
but not limited to, reimbursement of administration fees due
the administrative service organization pursuant to its
contract or contracts with the Department.
    (a-10) To the extent that participation, benefits, or
premiums under this Act are based on a person's service credit
under an Article of the Illinois Pension Code, service credit
terminated in exchange for an accelerated pension benefit
payment under Section 14-147.5, 15-185.5, or 16-190.5 of that
Code shall be included in determining a person's service
credit for the purposes of this Act.
    (b) State employees who become eligible for this program
on or after January 1, 1980 in positions normally requiring
actual performance of duty not less than 1/2 of a normal work
period but not equal to that of a normal work period, shall be
given the option of participating in the available program. If
the employee elects coverage, the State shall contribute on
behalf of such employee to the cost of the employee's benefit
and any applicable dependent supplement, that sum which bears
the same percentage as that percentage of time the employee
regularly works when compared to normal work period.
    (c) The basic non-contributory coverage from the basic
program of group health benefits shall be continued for each
employee not in pay status or on active service by reason of
(1) leave of absence due to illness or injury, (2) authorized
educational leave of absence or sabbatical leave, or (3)
military leave. This coverage shall continue until expiration
of authorized leave and return to active service, but not to
exceed 24 months for leaves under item (1) or (2). This
24-month limitation and the requirement of returning to active
service shall not apply to persons receiving ordinary or
accidental disability benefits or retirement benefits through
the appropriate State retirement system or benefits under the
Workers' Compensation or Occupational Disease Act.
    (d) The basic group life insurance coverage shall
continue, with full State contribution, where such person is
(1) absent from active service by reason of disability arising
from any cause other than self-inflicted, (2) on authorized
educational leave of absence or sabbatical leave, or (3) on
military leave.
    (e) Where the person is in non-pay status for a period in
excess of 30 days or on leave of absence, other than by reason
of disability, educational or sabbatical leave, or military
leave, such person may continue coverage only by making
personal payment equal to the amount normally contributed by
the State on such person's behalf. Such payments and coverage
may be continued: (1) until such time as the person returns to
a status eligible for coverage at State expense, but not to
exceed 24 months or (2) until such person's employment or
annuitant status with the State is terminated (exclusive of
any additional service imposed pursuant to law).
    (f) The Department shall establish by rule the extent to
which other employee benefits will continue for persons in
non-pay status or who are not in active service.
    (g) The State shall not pay the cost of the basic
non-contributory group life insurance, program of health
benefits and other employee benefits for members who are
survivors as defined by paragraphs (1) and (2) of subsection
(q) of Section 3 of this Act. The costs of benefits for these
survivors shall be paid by the survivors or by the University
of Illinois Cooperative Extension Service, or any combination
thereof. However, the State shall pay the amount of the
reduction in the cost of participation, if any, resulting from
the amendment to subsection (a) made by this amendatory Act of
the 91st General Assembly.
    (h) Those persons occupying positions with any department
as a result of emergency appointments pursuant to Section 8b.8
of the Personnel Code who are not considered employees under
this Act shall be given the option of participating in the
programs of group life insurance, health benefits and other
employee benefits. Such persons electing coverage may
participate only by making payment equal to the amount
normally contributed by the State for similarly situated
employees. Such amounts shall be determined by the Director.
Such payments and coverage may be continued until such time as
the person becomes an employee pursuant to this Act or such
person's appointment is terminated.
    (i) Any unit of local government within the State of
Illinois may apply to the Director to have its employees,
annuitants, and their dependents provided group health
coverage under this Act on a non-insured basis. To
participate, a unit of local government must agree to enroll
all of its employees, who may select coverage under any either
the State group health benefits plan made available by the
Department under the health benefits program established under
this Section or a health maintenance organization that has
contracted with the State to be available as a health care
provider for employees as defined in this Act. A unit of local
government must remit the entire cost of providing coverage
under the health benefits program established under this
Section the State group health benefits plan or, for coverage
under a health maintenance organization, an amount determined
by the Director based on an analysis of the sex, age,
geographic location, or other relevant demographic variables
for its employees, except that the unit of local government
shall not be required to enroll those of its employees who are
covered spouses or dependents under the State group health
benefits this plan or another group policy or plan providing
health benefits as long as (1) an appropriate official from
the unit of local government attests that each employee not
enrolled is a covered spouse or dependent under this plan or
another group policy or plan, and (2) at least 50% of the
employees are enrolled and the unit of local government remits
the entire cost of providing coverage to those employees,
except that a participating school district must have enrolled
at least 50% of its full-time employees who have not waived
coverage under the district's group health plan by
participating in a component of the district's cafeteria plan.
A participating school district is not required to enroll a
full-time employee who has waived coverage under the
district's health plan, provided that an appropriate official
from the participating school district attests that the
full-time employee has waived coverage by participating in a
component of the district's cafeteria plan. For the purposes
of this subsection, "participating school district" includes a
unit of local government whose primary purpose is education as
defined by the Department's rules.
    Employees of a participating unit of local government who
are not enrolled due to coverage under another group health
policy or plan may enroll in the event of a qualifying change
in status, special enrollment, special circumstance as defined
by the Director, or during the annual Benefit Choice Period. A
participating unit of local government may also elect to cover
its annuitants. Dependent coverage shall be offered on an
optional basis, with the costs paid by the unit of local
government, its employees, or some combination of the two as
determined by the unit of local government. The unit of local
government shall be responsible for timely collection and
transmission of dependent premiums.
    The Director shall annually determine monthly rates of
payment, subject to the following constraints:
        (1) In the first year of coverage, the rates shall be
    equal to the amount normally charged to State employees
    for elected optional coverages or for enrolled dependents
    coverages or other contributory coverages, or contributed
    by the State for basic insurance coverages on behalf of
    its employees, adjusted for differences between State
    employees and employees of the local government in age,
    sex, geographic location or other relevant demographic
    variables, plus an amount sufficient to pay for the
    additional administrative costs of providing coverage to
    employees of the unit of local government and their
    dependents.
        (2) In subsequent years, a further adjustment shall be
    made to reflect the actual prior years' claims experience
    of the employees of the unit of local government.
    In the case of coverage of local government employees
under a health maintenance organization, the Director shall
annually determine for each participating unit of local
government the maximum monthly amount the unit may contribute
toward that coverage, based on an analysis of (i) the age, sex,
geographic location, and other relevant demographic variables
of the unit's employees and (ii) the cost to cover those
employees under the State group health benefits plan. The
Director may similarly determine the maximum monthly amount
each unit of local government may contribute toward coverage
of its employees' dependents under a health maintenance
organization.
    Monthly payments by the unit of local government or its
employees for group health benefits plan or health maintenance
organization coverage shall be deposited in the Local
Government Health Insurance Reserve Fund.
    The Local Government Health Insurance Reserve Fund is
hereby created as a nonappropriated trust fund to be held
outside the State Treasury, with the State Treasurer as
custodian. The Local Government Health Insurance Reserve Fund
shall be a continuing fund not subject to fiscal year
limitations. The Local Government Health Insurance Reserve
Fund is not subject to administrative charges or charge-backs,
including but not limited to those authorized under Section 8h
of the State Finance Act. All revenues arising from the
administration of the health benefits program established
under this Section shall be deposited into the Local
Government Health Insurance Reserve Fund. Any interest earned
on moneys in the Local Government Health Insurance Reserve
Fund shall be deposited into the Fund. All expenditures from
this Fund shall be used for payments for health care benefits
for local government and rehabilitation facility employees,
annuitants, and dependents, and to reimburse the Department or
its administrative service organization for all expenses
incurred in the administration of benefits. No other State
funds may be used for these purposes.
    A local government employer's participation or desire to
participate in a program created under this subsection shall
not limit that employer's duty to bargain with the
representative of any collective bargaining unit of its
employees.
    (j) Any rehabilitation facility within the State of
Illinois may apply to the Director to have its employees,
annuitants, and their eligible dependents provided group
health coverage under this Act on a non-insured basis. To
participate, a rehabilitation facility must agree to enroll
all of its employees and remit the entire cost of providing
such coverage for its employees, except that the
rehabilitation facility shall not be required to enroll those
of its employees who are covered spouses or dependents under
this plan or another group policy or plan providing health
benefits as long as (1) an appropriate official from the
rehabilitation facility attests that each employee not
enrolled is a covered spouse or dependent under this plan or
another group policy or plan, and (2) at least 50% of the
employees are enrolled and the rehabilitation facility remits
the entire cost of providing coverage to those employees.
Employees of a participating rehabilitation facility who are
not enrolled due to coverage under another group health policy
or plan may enroll in the event of a qualifying change in
status, special enrollment, special circumstance as defined by
the Director, or during the annual Benefit Choice Period. A
participating rehabilitation facility may also elect to cover
its annuitants. Dependent coverage shall be offered on an
optional basis, with the costs paid by the rehabilitation
facility, its employees, or some combination of the 2 as
determined by the rehabilitation facility. The rehabilitation
facility shall be responsible for timely collection and
transmission of dependent premiums.
    The Director shall annually determine quarterly rates of
payment, subject to the following constraints:
        (1) In the first year of coverage, the rates shall be
    equal to the amount normally charged to State employees
    for elected optional coverages or for enrolled dependents
    coverages or other contributory coverages on behalf of its
    employees, adjusted for differences between State
    employees and employees of the rehabilitation facility in
    age, sex, geographic location or other relevant
    demographic variables, plus an amount sufficient to pay
    for the additional administrative costs of providing
    coverage to employees of the rehabilitation facility and
    their dependents.
        (2) In subsequent years, a further adjustment shall be
    made to reflect the actual prior years' claims experience
    of the employees of the rehabilitation facility.
    Monthly payments by the rehabilitation facility or its
employees for group health benefits shall be deposited in the
Local Government Health Insurance Reserve Fund.
    (k) Any domestic violence shelter or service within the
State of Illinois may apply to the Director to have its
employees, annuitants, and their dependents provided group
health coverage under this Act on a non-insured basis. To
participate, a domestic violence shelter or service must agree
to enroll all of its employees and pay the entire cost of
providing such coverage for its employees. The domestic
violence shelter shall not be required to enroll those of its
employees who are covered spouses or dependents under this
plan or another group policy or plan providing health benefits
as long as (1) an appropriate official from the domestic
violence shelter attests that each employee not enrolled is a
covered spouse or dependent under this plan or another group
policy or plan and (2) at least 50% of the employees are
enrolled and the domestic violence shelter remits the entire
cost of providing coverage to those employees. Employees of a
participating domestic violence shelter who are not enrolled
due to coverage under another group health policy or plan may
enroll in the event of a qualifying change in status, special
enrollment, or special circumstance as defined by the Director
or during the annual Benefit Choice Period. A participating
domestic violence shelter may also elect to cover its
annuitants. Dependent coverage shall be offered on an optional
basis, with employees, or some combination of the 2 as
determined by the domestic violence shelter or service. The
domestic violence shelter or service shall be responsible for
timely collection and transmission of dependent premiums.
    The Director shall annually determine rates of payment,
subject to the following constraints:
        (1) In the first year of coverage, the rates shall be
    equal to the amount normally charged to State employees
    for elected optional coverages or for enrolled dependents
    coverages or other contributory coverages on behalf of its
    employees, adjusted for differences between State
    employees and employees of the domestic violence shelter
    or service in age, sex, geographic location or other
    relevant demographic variables, plus an amount sufficient
    to pay for the additional administrative costs of
    providing coverage to employees of the domestic violence
    shelter or service and their dependents.
        (2) In subsequent years, a further adjustment shall be
    made to reflect the actual prior years' claims experience
    of the employees of the domestic violence shelter or
    service.
    Monthly payments by the domestic violence shelter or
service or its employees for group health insurance shall be
deposited in the Local Government Health Insurance Reserve
Fund.
    (l) A public community college or entity organized
pursuant to the Public Community College Act may apply to the
Director initially to have only annuitants not covered prior
to July 1, 1992 by the district's health plan provided health
coverage under this Act on a non-insured basis. The community
college must execute a 2-year contract to participate in the
Local Government Health Plan. Any annuitant may enroll in the
event of a qualifying change in status, special enrollment,
special circumstance as defined by the Director, or during the
annual Benefit Choice Period.
    The Director shall annually determine monthly rates of
payment subject to the following constraints: for those
community colleges with annuitants only enrolled, first year
rates shall be equal to the average cost to cover claims for a
State member adjusted for demographics, Medicare
participation, and other factors; and in the second year, a
further adjustment of rates shall be made to reflect the
actual first year's claims experience of the covered
annuitants.
    (l-5) The provisions of subsection (l) become inoperative
on July 1, 1999.
    (m) The Director shall adopt any rules deemed necessary
for implementation of this amendatory Act of 1989 (Public Act
86-978).
    (n) Any child advocacy center within the State of Illinois
may apply to the Director to have its employees, annuitants,
and their dependents provided group health coverage under this
Act on a non-insured basis. To participate, a child advocacy
center must agree to enroll all of its employees and pay the
entire cost of providing coverage for its employees. The child
advocacy center shall not be required to enroll those of its
employees who are covered spouses or dependents under this
plan or another group policy or plan providing health benefits
as long as (1) an appropriate official from the child advocacy
center attests that each employee not enrolled is a covered
spouse or dependent under this plan or another group policy or
plan and (2) at least 50% of the employees are enrolled and the
child advocacy center remits the entire cost of providing
coverage to those employees. Employees of a participating
child advocacy center who are not enrolled due to coverage
under another group health policy or plan may enroll in the
event of a qualifying change in status, special enrollment, or
special circumstance as defined by the Director or during the
annual Benefit Choice Period. A participating child advocacy
center may also elect to cover its annuitants. Dependent
coverage shall be offered on an optional basis, with the costs
paid by the child advocacy center, its employees, or some
combination of the 2 as determined by the child advocacy
center. The child advocacy center shall be responsible for
timely collection and transmission of dependent premiums.
    The Director shall annually determine rates of payment,
subject to the following constraints:
        (1) In the first year of coverage, the rates shall be
    equal to the amount normally charged to State employees
    for elected optional coverages or for enrolled dependents
    coverages or other contributory coverages on behalf of its
    employees, adjusted for differences between State
    employees and employees of the child advocacy center in
    age, sex, geographic location, or other relevant
    demographic variables, plus an amount sufficient to pay
    for the additional administrative costs of providing
    coverage to employees of the child advocacy center and
    their dependents.
        (2) In subsequent years, a further adjustment shall be
    made to reflect the actual prior years' claims experience
    of the employees of the child advocacy center.
    Monthly payments by the child advocacy center or its
employees for group health insurance shall be deposited into
the Local Government Health Insurance Reserve Fund.
(Source: P.A. 100-587, eff. 6-4-18.)
 
    (5 ILCS 375/13)  (from Ch. 127, par. 533)
    Sec. 13. There is established a Group Insurance Premium
Fund administered by the Director which shall include: (1)
amounts paid by covered members for optional life insurance
and (2) refunds which may be received from (a) the group
carrier or carriers which may result from favorable experience
as described in Section 12 herein or (b) from any other source
from which the State is reasonably and properly entitled to
refund as a result of the life insurance program. The Group
Insurance Premium Fund shall be a continuing fund not subject
to fiscal year limitations.
    The State of Illinois shall at least once each month make
payment on behalf of each member, except one who is a member by
virtue of participation in a program created under subsection
(i), (j), (k), or (l) of Section 10 of this Act, to the
appropriate carrier or, if applicable, carriers insuring State
members under the contracted group life insurance program
authorized by this Act.
    Refunds to members for premiums paid for optional life
insurance coverage may be paid from the Group Insurance
Premium Fund without regard to the fact that the premium being
refunded may have been paid in a different fiscal year.
(Source: P.A. 95-632, eff. 9-25-07.)
 
    (5 ILCS 375/13.1)  (from Ch. 127, par. 533.1)
    Sec. 13.1. (a) All contributions, appropriations,
interest, and dividend payments to fund the program of health
benefits and other employee benefits, and all other revenues
arising from the administration of any employee health
benefits program, shall be deposited in a trust fund outside
the State Treasury, with the State Treasurer as ex-officio
custodian, to be known as the Health Insurance Reserve Fund.
    (b) Upon the adoption of a self-insurance health plan, any
monies attributable to the group health insurance program
shall be deposited in or transferred to the Health Insurance
Reserve Fund for use by the Department. As of the effective
date of this amendatory Act of 1986, the Department shall
certify to the Comptroller the amount of money in the Group
Insurance Premium Fund attributable to the State group health
insurance program and the Comptroller shall transfer such
money from the Group Insurance Premium Fund to the Health
Insurance Reserve Fund. Contributions by the State to the
Health Insurance Reserve Fund to meet the requirements of this
Act, as established by the Director, from the General Revenue
Fund and the Road Fund to the Health Insurance Reserve Fund
shall be by annual appropriations, and all other contributions
to meet the requirements of the programs of health benefits or
other employee benefits shall be deposited in the Health
Insurance Reserve Fund. The Department shall draw the
appropriation from the General Revenue Fund and the Road Fund
from time to time as necessary to make expenditures authorized
under this Act.
    The Director may employ such assistance and services and
may purchase such goods as may be necessary for the proper
development and administration of any of the benefit programs
authorized by this Act. The Director may promulgate rules and
regulations in regard to the administration of these programs.
    All monies received by the Department for deposit in or
transfer to the Health Insurance Reserve Fund, through
appropriation or otherwise, shall be used to provide for the
making of payments to claimants and providers and to reimburse
the Department for all expenses directly incurred relating to
Department development and administration of the program of
health benefits and other employee benefits.
    Any administrative service organization administering any
self-insurance health plan and paying claims and benefits
under authority of this Act may receive, pursuant to written
authorization and direction of the Director, an initial
transfer and periodic transfers of funds from the Health
Insurance Reserve Fund in amounts determined by the Director
who may consider the amount recommended by the administrative
service organization. Notwithstanding any other statute, such
transferred funds shall be retained by the administrative
service organization in a separate account provided by any
bank as defined by the Illinois Banking Act. The Department
may promulgate regulations further defining the banks
authorized to accept such funds and all methodology for
transfer of such funds. Any interest earned by monies in such
account shall inure to the Health Insurance Reserve Fund,
shall remain in such account and shall be used exclusively to
pay claims and benefits under this Act. Such transferred funds
shall be used exclusively for administrative service
organization payment of claims to claimants and providers
under the self-insurance health plan by the drawing of checks
against such account. The administrative service organization
may not use such transferred funds, or interest accrued
thereon, for any other purpose including, but not limited to,
reimbursement of administrative expenses or payments of
administration fees due the organization pursuant to its
contract or contracts with the Department of Central
Management Services.
    The account of the administrative service organization
established under this Section, any transfers from the Health
Insurance Reserve Fund to such account and the use of such
account and funds shall be subject to (1) audit by the
Department or private contractor authorized by the Department
to conduct audits, and (2) post audit pursuant to the Illinois
State Auditing Act.
    The Department of Central Management Services, or any
successor agency designated to procure healthcare contracts
pursuant to this Act, is authorized to establish funds,
separate accounts provided by any bank or banks as defined by
the Illinois Banking Act, or separate accounts provided by any
savings and loan association or associations as defined by the
Illinois Savings and Loan Act of 1985 to be held by the
Director, outside the State treasury, for the purpose of
receiving the transfer of moneys from the Health Insurance
Reserve Fund. The Department may promulgate rules further
defining the methodology for the transfers. Any interest
earned by monies in the funds or accounts shall inure to the
Health Insurance Reserve Fund. The transferred moneys, and
interest accrued thereon, shall be used exclusively for
transfers to administrative service organizations or their
financial institutions for payments of claims to claimants and
providers under the self-insurance health plan. The
transferred moneys, and interest accrued thereon, shall not be
used for any other purpose including, but not limited to,
reimbursement of administration fees due the administrative
service organization pursuant to its contract or contracts
with the Department.
    (c) The Director, with the advice and consent of the
Commission, shall establish premiums for optional coverage for
dependents of eligible members for the health plans. The
eligible members shall be responsible for their portion of
such optional premium. The State shall contribute an amount
per month for each eligible member who has enrolled one or more
dependents under the health plans. Such contribution shall be
made directly to the Health Insurance Reserve Fund. Those
employees described in subsection (b) of Section 9 of this Act
shall be allowed to continue in the health plan by making
personal payments with the premiums to be deposited in the
Health Insurance Reserve Fund.
    (d) The Health Insurance Reserve Fund shall be a
continuing fund not subject to fiscal year limitations. All
expenditures from that fund shall be at the direction of the
Director and shall be only for the purpose of:
        (1) the payment of administrative expenses incurred by
    the Department for the program of health benefits or other
    employee benefit programs, including but not limited to
    the costs of audits or actuarial consultations,
    professional and contractual services, electronic data
    processing systems and services, and expenses in
    connection with the development and administration of such
    programs;
        (2) the payment of administrative expenses incurred by
    an the Administrative Service Organization;
        (3) the payment of health benefits;
        (3.5) the payment of medical expenses incurred by the
    Department for the treatment of employees who suffer
    accidental injury or death within the scope of their
    employment;
        (4) refunds to employees for erroneous payments of
    their selected health insurance dependent coverage;
        (5) payment of premium for stop-loss or re-insurance;
        (6) payment of premium to health maintenance
    organizations pursuant to Section 6.1 of this Act;
        (7) payment of adoption program benefits; and
        (8) payment of other benefits offered to members and
    dependents under this Act.
(Source: P.A. 98-488, eff. 8-16-13.)
 
    Section 10. The Illinois Pension Code is amended by
changing Section 15-158.3 as follows:
 
    (40 ILCS 5/15-158.3)
    Sec. 15-158.3. Reports on cost reduction; effect on
retirement at any age with 30 years of service.
    (a) On or before November 15, 2001 and on or before
November 15th of each year thereafter, the Board shall have
the System's actuary prepare a report showing, on a fiscal
year by fiscal year basis, the actual rate of participation in
the self-managed plan authorized by Section 15-158.2, (i) by
employees of the System's covered higher educational
institutions who were hired on or after the implementation
date of the self-managed plan and (ii) by other System
participants.
    (b) On or before November 15th of 2001 and on or before
November 15th of each year thereafter, the Illinois Board of
Higher Education, in conjunction with the Bureau of the Budget
(now Governor's Office of Management and Budget) shall prepare
a report showing, on a fiscal year by fiscal year basis, the
amount by which the costs associated with compensable sick
leave have been reduced as a result of the termination of
compensable sick leave accrual on and after January 1, 1998 by
employees of higher education institutions who are
participants in the System.
    (c) (Blank). On or before November 15 of 2001 and on or
before November 15th of each year thereafter, the Department
of Central Management Services shall prepare a report showing,
on a fiscal year by fiscal year basis, the amount by which the
State's cost for health insurance coverage under the State
Employees Group Insurance Act of 1971 for retirees of the
State's universities and their survivors has declined as a
result of requiring some of those retirees and survivors to
contribute to the cost of their basic health insurance. These
year-by-year reductions in cost must be quantified both in
dollars and as a level percentage of payroll covered by the
System.
    (d) The report reports required under subsection
subsections (b) and (c) shall be disseminated to the Board,
the Pension Laws Commission (until it ceases to exist), the
Commission on Government Forecasting and Accountability, the
Illinois Board of Higher Education, and the Governor.
    (e) The report reports required under subsection
subsections (b) and (c) shall be taken into account by the
Pension Laws Commission (or its successor, the Commission on
Government Forecasting and Accountability) in making any
recommendation to extend by legislation beyond December 31,
2002 the provision that allows a System participant to retire
at any age with 30 or more years of service as authorized in
Section 15-135.
(Source: P.A. 95-83, eff. 8-13-07.)
 
    Section 99. Effective date. This Act takes effect July 1,
2021.