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Public Act 096-1232 | ||||
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AN ACT concerning finance.
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Be it enacted by the People of the State of Illinois,
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represented in the General Assembly:
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Section 5. The State Employees Group Insurance Act of 1971 | ||||
is amended by changing Section 10 as follows:
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(5 ILCS 375/10) (from Ch. 127, par. 530)
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Sec. 10. Payments by State; premiums.
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(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, 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
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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.
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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
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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
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annuitant under the State Universities Retirement System.
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(a-1) Beginning January 1, 1998, for each person who | ||
becomes a new SERS
annuitant and participates in the basic | ||
program of group health benefits, the
State shall contribute | ||
toward the cost of the annuitant's
coverage under the basic |
program of group health benefits an amount equal
to 5% of that | ||
cost for each full year of creditable service upon which the
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annuitant's retirement annuity is based, up to a maximum of | ||
100% for an
annuitant with 20 or more years of creditable | ||
service.
The remainder of the cost of a new SERS annuitant's | ||
coverage under the basic
program of group health benefits shall | ||
be the responsibility of the
annuitant. In the case of a new | ||
SERS annuitant who has elected to receive an alternative | ||
retirement cancellation payment under Section 14-108.5 of the | ||
Illinois Pension Code in lieu of an annuity, for the purposes | ||
of this subsection the annuitant shall be deemed to be | ||
receiving a retirement annuity based on the number of years of | ||
creditable service that the annuitant had established at the | ||
time of his or her termination of service under SERS.
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(a-2) Beginning January 1, 1998, for each person who | ||
becomes a new SERS
survivor and participates in the basic | ||
program of group health benefits, the
State shall contribute | ||
toward the cost of the survivor's
coverage under the basic | ||
program of group health benefits an amount equal
to 5% of that | ||
cost for each full year of the deceased employee's or deceased
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annuitant's creditable service in the State Employees' | ||
Retirement System of
Illinois on the date of death, up to a | ||
maximum of 100% for a survivor of an
employee or annuitant with | ||
20 or more years of creditable service. The
remainder of the | ||
cost of the new SERS survivor's coverage under the basic
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program of group health benefits shall be the responsibility of |
the survivor. In the case of a new SERS survivor who was the | ||
dependent of an annuitant who elected to receive an alternative | ||
retirement cancellation payment under Section 14-108.5 of the | ||
Illinois Pension Code in lieu of an annuity, for the purposes | ||
of this subsection the deceased annuitant's creditable service | ||
shall be determined as of the date of termination of service | ||
rather than the date of death.
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(a-3) Beginning January 1, 1998, for each person who | ||
becomes a new SURS
annuitant and participates in the basic | ||
program of group health benefits, the
State shall contribute | ||
toward the cost of the annuitant's
coverage under the basic | ||
program of group health benefits an amount equal
to 5% of that | ||
cost for each full year of creditable service upon which the
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annuitant's retirement annuity is based, up to a maximum of | ||
100% for an
annuitant with 20 or more years of creditable | ||
service.
The remainder of the cost of a new SURS annuitant's | ||
coverage under the basic
program of group health benefits shall | ||
be the responsibility of the
annuitant.
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(a-4) (Blank).
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(a-5) Beginning January 1, 1998, for each person who | ||
becomes a new SURS
survivor and participates in the basic | ||
program of group health benefits, the
State shall contribute | ||
toward the cost of the survivor's coverage under the
basic | ||
program of group health benefits an amount equal to 5% of that | ||
cost for
each full year of the deceased employee's or deceased | ||
annuitant's creditable
service in the State Universities |
Retirement System on the date of death, up to
a maximum of 100% | ||
for a survivor of an
employee or annuitant with 20 or more | ||
years of creditable service. The
remainder of the cost of the | ||
new SURS survivor's coverage under the basic
program of group | ||
health benefits shall be the responsibility of the survivor.
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(a-6) Beginning July 1, 1998, for each person who becomes a | ||
new TRS
State annuitant and participates in the basic program | ||
of group health benefits,
the State shall contribute toward the | ||
cost of the annuitant's coverage under
the basic program of | ||
group health benefits an amount equal to 5% of that cost
for | ||
each full year of creditable service
as a teacher as defined in | ||
paragraph (2), (3), or (5) of Section 16-106 of the
Illinois | ||
Pension Code
upon which the annuitant's retirement annuity is | ||
based, up to a maximum of
100%;
except that
the State | ||
contribution shall be 12.5% per year (rather than 5%) for each | ||
full
year of creditable service as a regional superintendent or | ||
assistant regional
superintendent of schools. The
remainder of | ||
the cost of a new TRS State annuitant's coverage under the | ||
basic
program of group health benefits shall be the | ||
responsibility of the
annuitant.
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(a-7) Beginning July 1, 1998, for each person who becomes a | ||
new TRS
State survivor and participates in the basic program of | ||
group health benefits,
the State shall contribute toward the | ||
cost of the survivor's coverage under the
basic program of | ||
group health benefits an amount equal to 5% of that cost for
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each full year of the deceased employee's or deceased |
annuitant's creditable
service
as a teacher as defined in | ||
paragraph (2), (3), or (5) of Section 16-106 of the
Illinois | ||
Pension Code
on the date of death, up to a maximum of 100%;
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except that the State contribution shall be 12.5% per year | ||
(rather than 5%) for
each full year of the deceased employee's | ||
or deceased annuitant's creditable
service as a regional | ||
superintendent or assistant regional superintendent of
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schools.
The remainder of
the cost of the new TRS State | ||
survivor's coverage under the basic program of
group health | ||
benefits shall be the responsibility of the survivor.
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(a-8) A new SERS annuitant, new SERS survivor, new SURS
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annuitant, new SURS survivor, new TRS State
annuitant, or new | ||
TRS State survivor may waive or terminate coverage in
the | ||
program of group health benefits. Any such annuitant or | ||
survivor
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 or survivor
may | ||
not re-enroll in the program.
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(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.
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A separate calculation of the premiums based upon the | ||
actual cost of each
health care plan shall be so certified.
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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.
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The Department of Healthcare and Family 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.
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(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
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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.
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(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)
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military leave with pay and benefits. 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.
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(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 | ||
with pay and benefits.
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(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 with pay and benefits, 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, (2) until such person's | ||
employment or annuitant status
with the State is terminated, or | ||
(3) for a maximum period of 4 years for
members on military | ||
leave with pay and benefits and military leave without pay
and | ||
benefits (exclusive of any additional service imposed pursuant | ||
to law).
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(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.
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(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
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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.
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(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.
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(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 either the State group
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health benefits plan 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 State group health benefits plan
or, for coverage | ||
under a health maintenance organization, an amount determined
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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
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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 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
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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.
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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.
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The Director shall annually determine monthly rates of | ||
payment, subject
to the following constraints:
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(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.
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(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.
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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
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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.
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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.
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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.
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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.
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(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
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long as (1) an appropriate official from the child advocacy
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center attests that each employee not enrolled is a covered
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spouse or dependent under this plan or another group policy or
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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. 95-331, eff. 8-21-07; 95-632, eff. 9-25-07; | ||
95-707, eff. 1-11-08; 96-756, eff. 1-1-10.)
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Section 99. Effective date. This Act takes effect upon | ||
becoming law.
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