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Public Act 91-0395
SB211 Enrolled LRB9102763EGfg
AN ACT in relation to public employee benefits, amending
named Acts.
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 3 and 10 as follows:
(5 ILCS 375/3) (from Ch. 127, par. 523)
Sec. 3. Definitions. Unless the context otherwise
requires, the following words and phrases as used in this Act
shall have the following meanings. The Department may define
these and other words and phrases separately for the purpose
of implementing specific programs providing benefits under
this Act.
(a) "Administrative service organization" means any
person, firm or corporation experienced in the handling of
claims which is fully qualified, financially sound and
capable of meeting the service requirements of a contract of
administration executed with the Department.
(b) "Annuitant" means (1) an employee who retires, or
has retired, on or after January 1, 1966 on an immediate
annuity under the provisions of Articles 2, 14, 15 (including
an employee who has retired under the optional retirement
program established under Section 15-158.2), paragraphs (2),
(3), or (5) of Section 16-106, or Article 18 of the Illinois
Pension Code; (2) any person who was receiving group
insurance coverage under this Act as of March 31, 1978 by
reason of his status as an annuitant, even though the annuity
in relation to which such coverage was provided is a
proportional annuity based on less than the minimum period of
service required for a retirement annuity in the system
involved; (3) any person 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; (4) the spouse of any person who is receiving a
retirement annuity under Article 18 of the Illinois Pension
Code and who is covered under a group health insurance
program sponsored by a governmental employer other than the
State of Illinois and who has irrevocably elected to waive
his or her coverage under this Act and to have his or her
spouse considered as the "annuitant" under this Act and not
as a "dependent"; or (5) an employee who retires, or has
retired, from a qualified position, as determined according
to rules promulgated by the Director, under a qualified local
government or a qualified rehabilitation facility or a
qualified domestic violence shelter or service. (For
definition of "retired employee", see (p) post).
(b-5) "New SERS annuitant" means a person who, on or
after January 1, 1998, becomes an annuitant, as defined in
subsection (b), by virtue of beginning to receive a
retirement annuity under Article 14 of the Illinois Pension
Code, and is eligible to participate in the basic program of
group health benefits provided for annuitants under this Act.
(b-6) "New SURS annuitant" means a person who (1), on or
after January 1, 1998, becomes an annuitant, as defined in
subsection (b), by virtue of beginning to receive a
retirement annuity under Article 15 of the Illinois Pension
Code, (2) has not made the election authorized under Section
15-135.1 of the Illinois Pension Code, and (3) is eligible to
participate in the basic program of group health benefits
provided for annuitants under this Act.
(b-7) "New TRS State annuitant" means a person who, on
or after July 1, 1998, becomes an annuitant, as defined in
subsection (b), by virtue of beginning to receive a
retirement annuity under Article 16 of the Illinois Pension
Code based on service as a teacher as defined in paragraph
(2), (3), or (5) of Section 16-106 of that Code, and is
eligible to participate in the basic program of group health
benefits provided for annuitants under this Act.
(c) "Carrier" means (1) an insurance company, a
corporation organized under the Limited Health Service
Organization Act or the Voluntary Health Services Plan Act, a
partnership, or other nongovernmental organization, which is
authorized to do group life or group health insurance
business in Illinois, or (2) the State of Illinois as a
self-insurer.
(d) "Compensation" means salary or wages payable on a
regular payroll by the State Treasurer on a warrant of the
State Comptroller out of any State, trust or federal fund, or
by the Governor of the State through a disbursing officer of
the State out of a trust or out of federal funds, or by any
Department out of State, trust, federal or other funds held
by the State Treasurer or the Department, to any person for
personal services currently performed, and ordinary or
accidental disability benefits under Articles 2, 14, 15
(including ordinary or accidental disability benefits under
the optional retirement program established under Section
15-158.2), paragraphs (2), (3), or (5) of Section 16-106, or
Article 18 of the Illinois Pension Code, for disability
incurred after January 1, 1966, or benefits payable under the
Workers' Compensation or Occupational Diseases Act or
benefits payable under a sick pay plan established in
accordance with Section 36 of the State Finance Act.
"Compensation" also means salary or wages paid to an employee
of any qualified local government or qualified rehabilitation
facility or a qualified domestic violence shelter or service.
(e) "Commission" means the State Employees Group
Insurance Advisory Commission authorized by this Act.
Commencing July 1, 1984, "Commission" as used in this Act
means the Illinois Economic and Fiscal Commission as
established by the Legislative Commission Reorganization Act
of 1984.
(f) "Contributory", when referred to as contributory
coverage, shall mean optional coverages or benefits elected
by the member toward the cost of which such member makes
contribution, or which are funded in whole or in part through
the acceptance of a reduction in earnings or the foregoing of
an increase in earnings by an employee, as distinguished from
noncontributory coverage or benefits which are paid entirely
by the State of Illinois without reduction of the member's
salary.
(g) "Department" means any department, institution,
board, commission, officer, court or any agency of the State
government receiving appropriations and having power to
certify payrolls to the Comptroller authorizing payments of
salary and wages against such appropriations as are made by
the General Assembly from any State fund, or against trust
funds held by the State Treasurer and includes boards of
trustees of the retirement systems created by Articles 2, 14,
15, 16 and 18 of the Illinois Pension Code. "Department"
also includes the Illinois Comprehensive Health Insurance
Board, the Board of Examiners established under the Illinois
Public Accounting Act, and the Illinois Rural Bond Bank.
(h) "Dependent", when the term is used in the context of
the health and life plan, means a member's spouse and any
unmarried child (1) from birth to age 19 including an adopted
child, a child who lives with the member from the time of the
filing of a petition for adoption until entry of an order of
adoption, a stepchild or recognized child who lives with the
member in a parent-child relationship, or a child who lives
with the member if such member is a court appointed guardian
of the child, or (2) age 19 to 23 enrolled as a full-time
student in any accredited school, financially dependent upon
the member, and eligible as a dependent for Illinois State
income tax purposes, or (3) age 19 or over who is mentally or
physically handicapped as defined in the Illinois Insurance
Code. For the health plan only, the term "dependent" also
includes any person enrolled prior to the effective date of
this Section who is dependent upon the member to the extent
that the member may claim such person as a dependent for
Illinois State income tax deduction purposes; no other such
person may be enrolled.
(i) "Director" means the Director of the Illinois
Department of Central Management Services.
(j) "Eligibility period" means the period of time a
member has to elect enrollment in programs or to select
benefits without regard to age, sex or health.
(k) "Employee" means and includes each officer or
employee in the service of a department who (1) receives his
compensation for service rendered to the department on a
warrant issued pursuant to a payroll certified by a
department or on a warrant or check issued and drawn by a
department upon a trust, federal or other fund or on a
warrant issued pursuant to a payroll certified by an elected
or duly appointed officer of the State or who receives
payment of the performance of personal services on a warrant
issued pursuant to a payroll certified by a Department and
drawn by the Comptroller upon the State Treasurer against
appropriations made by the General Assembly from any fund or
against trust funds held by the State Treasurer, and (2) is
employed full-time or part-time in a position normally
requiring actual performance of duty during not less than 1/2
of a normal work period, as established by the Director in
cooperation with each department, except that persons elected
by popular vote will be considered employees during the
entire term for which they are elected regardless of hours
devoted to the service of the State, and (3) except that
"employee" does not include any person who is not eligible by
reason of such person's employment to participate in one of
the State retirement systems under Articles 2, 14, 15 (either
the regular Article 15 system or the optional retirement
program established under Section 15-158.2) or 18, or under
paragraph (2), (3), or (5) of Section 16-106, of the Illinois
Pension Code, but such term does include persons who are
employed during the 6 month qualifying period under Article
14 of the Illinois Pension Code. Such term also includes any
person who (1) after January 1, 1966, is receiving ordinary
or accidental disability benefits under Articles 2, 14, 15
(including ordinary or accidental disability benefits under
the optional retirement program established under Section
15-158.2), paragraphs (2), (3), or (5) of Section 16-106, or
Article 18 of the Illinois Pension Code, for disability
incurred after January 1, 1966, (2) receives total permanent
or total temporary disability under the Workers' Compensation
Act or Occupational Disease Act as a result of injuries
sustained or illness contracted in the course of employment
with the State of Illinois, or (3) is not otherwise covered
under this Act and 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. However, a person who satisfies
the criteria of the foregoing definition of "employee" except
that such person is 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
is also an "employee" for the purposes of this Act.
"Employee" also includes any person receiving or eligible for
benefits under a sick pay plan established in accordance with
Section 36 of the State Finance Act. "Employee" also includes
each officer or employee in the service of a qualified local
government, including persons appointed as trustees of
sanitary districts regardless of hours devoted to the service
of the sanitary district, and each employee in the service of
a qualified rehabilitation facility and each full-time
employee in the service of a qualified domestic violence
shelter or service, as determined according to rules
promulgated by the Director.
(l) "Member" means an employee, annuitant, retired
employee or survivor.
(m) "Optional coverages or benefits" means those
coverages or benefits available to the member on his or her
voluntary election, and at his or her own expense.
(n) "Program" means the group life insurance, health
benefits and other employee benefits designed and contracted
for by the Director under this Act.
(o) "Health plan" means a self-insured health insurance
program offered by the State of Illinois for the purposes of
benefiting employees by means of providing, among others,
wellness programs, utilization reviews, second opinions and
medical fee reviews, as well as for paying for hospital and
medical care up to the maximum coverage provided by the plan,
to its members and their dependents.
(p) "Retired employee" means any person who would be an
annuitant as that term is defined herein but for the fact
that such person retired prior to January 1, 1966. Such term
also includes any person formerly employed by the University
of Illinois in the Cooperative Extension Service who would be
an annuitant but for the fact that such person 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.
(p-6) "New SURS retired employee" means a person who, on
or after January 1, 1998, becomes a retired employee, as
defined in subsection (p), by virtue of being a person
formerly employed by the University of Illinois in the
Cooperative Extension Service who 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, and who is eligible to participate in
the basic program of group health benefits provided for
retired employees under this Act.
(q) "Survivor" means a person receiving an annuity as a
survivor of an employee or of an annuitant. "Survivor" also
includes: (1) the surviving dependent of a person who
satisfies the definition of "employee" except that such
person is 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; and (2)
the surviving dependent of any person formerly employed by
the University of Illinois in the Cooperative Extension
Service who would be an annuitant except for the fact that
such person 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.
(q-5) "New SERS survivor" means a survivor, as defined
in subsection (q), whose annuity is paid under Article 14 of
the Illinois Pension Code and is based on the death of (i) an
employee whose death occurs on or after January 1, 1998, or
(ii) a new SERS annuitant as defined in subsection (b-5).
(q-6) "New SURS survivor" means a survivor, as defined
in subsection (q), whose annuity is paid under Article 15 of
the Illinois Pension Code and is based on the death of (i) an
employee whose death occurs on or after January 1, 1998, or
(ii) a new SURS annuitant as defined in subsection (b-6), or
(iii) a new SURS retired employee as defined in subsection
(p-6).
(q-7) "New TRS State survivor" means a survivor, as
defined in subsection (q), whose annuity is paid under
Article 16 of the Illinois Pension Code and is based on the
death of (i) an employee who is a teacher as defined in
paragraph (2), (3), or (5) of Section 16-106 of that Code and
whose death occurs on or after July 1, 1998, or (ii) a new
TRS State annuitant as defined in subsection (b-7).
(r) "Medical services" means the services provided
within the scope of their licenses by practitioners in all
categories licensed under the Medical Practice Act of 1987.
(s) "Unit of local government" means any county,
municipality, township, school district, special district or
other unit, designated as a unit of local government by law,
which exercises limited governmental powers or powers in
respect to limited governmental subjects, any not-for-profit
association with a membership that primarily includes
townships and township officials, that has duties that
include provision of research service, dissemination of
information, and other acts for the purpose of improving
township government, and that is funded wholly or partly in
accordance with Section 85-15 of the Township Code; any
not-for-profit corporation or association, with a membership
consisting primarily of municipalities, that operates its own
utility system, and provides research, training,
dissemination of information, or other acts to promote
cooperation between and among municipalities that provide
utility services and for the advancement of the goals and
purposes of its membership; and the Illinois Association of
Park Districts. "Qualified local government" means a unit of
local government approved by the Director and participating
in a program created under subsection (i) of Section 10 of
this Act.
(t) "Qualified rehabilitation facility" means any
not-for-profit organization that is accredited by the
Commission on Accreditation of Rehabilitation Facilities or
certified by the Department of Human Services (as successor
to the Department of Mental Health and Developmental
Disabilities) to provide services to persons with
disabilities and which receives funds from the State of
Illinois for providing those services, approved by the
Director and participating in a program created under
subsection (j) of Section 10 of this Act.
(u) "Qualified domestic violence shelter or service"
means any Illinois domestic violence shelter or service and
its administrative offices funded by the Department of Human
Services (as successor to the Illinois Department of Public
Aid), approved by the Director and participating in a program
created under subsection (k) of Section 10.
(v) "TRS benefit recipient" means a person who:
(1) is not a "member" as defined in this Section;
and
(2) is receiving a monthly benefit or retirement
annuity under Article 16 of the Illinois Pension Code;
and
(3) either (i) has at least 8 years of creditable
service under Article 16 of the Illinois Pension Code, or
(ii) was enrolled in the health insurance program offered
under that Article on January 1, 1996, or (iii) is the
survivor of a benefit recipient who had at least 8 years
of creditable service under Article 16 of the Illinois
Pension Code or was enrolled in the health insurance
program offered under that Article on the effective date
of this amendatory Act of 1995, or (iv) is a recipient or
survivor of a recipient of a disability benefit under
Article 16 of the Illinois Pension Code.
(w) "TRS dependent beneficiary" means a person who:
(1) is not a "member" or "dependent" as defined in
this Section; and
(2) is a TRS benefit recipient's: (A) spouse, (B)
dependent parent who is receiving at least half of his or
her support from the TRS benefit recipient, or (C)
unmarried natural or adopted child who is (i) under age
19, or (ii) enrolled as a full-time student in an
accredited school, financially dependent upon the TRS
benefit recipient, eligible as a dependent for Illinois
State income tax purposes, and either is under age 24 or
was, on January 1, 1996, participating as a dependent
beneficiary in the health insurance program offered under
Article 16 of the Illinois Pension Code, or (iii) age 19
or over who is mentally or physically handicapped as
defined in the Illinois Insurance Code.
(x) "Military leave with pay and benefits" refers to
individuals in basic training for reserves, special/advanced
training, annual training, emergency call up, or activation
by the President of the United States with approved pay and
benefits.
(y) "Military leave without pay and benefits" refers to
individuals who enlist for active duty in a regular component
of the U.S. Armed Forces or other duty not specified or
authorized under military leave with pay and benefits.
(z) "Community college benefit recipient" means a person
who:
(1) is not a "member" as defined in this Section;
and
(2) is receiving a monthly survivor's annuity or
retirement annuity under Article 15 of the Illinois
Pension Code; and
(3) either (i) was a full-time employee of a
community college district or an association of community
college boards created under the Public Community College
Act (other than an employee whose last employer under
Article 15 of the Illinois Pension Code was a community
college district subject to Article VII of the Public
Community College Act) and was eligible to participate in
a group health benefit plan as an employee during the
time of employment with a community college district
(other than a community college district subject to
Article VII of the Public Community College Act) or an
association of community college boards, or (ii) is the
survivor of a person described in item (i).
(aa) "Community college dependent beneficiary" means a
person who:
(1) is not a "member" or "dependent" as defined in
this Section; and
(2) is a community college benefit recipient's: (A)
spouse, (B) dependent parent who is receiving at least
half of his or her support from the community college
benefit recipient, or (C) unmarried natural or adopted
child who is (i) under age 19, or (ii) enrolled as a
full-time student in an accredited school, financially
dependent upon the community college benefit recipient,
eligible as a dependent for Illinois State income tax
purposes and under age 23, or (iii) age 19 or over and
mentally or physically handicapped as defined in the
Illinois Insurance Code.
(Source: P.A. 89-21, eff. 6-21-95; 89-25, eff. 6-21-95;
89-76, eff. 7-1-95; 89-324, eff. 8-13-95; 89-430, eff.
12-15-95; 89-502, eff. 7-1-96; 89-507, eff. 7-1-97; 89-628,
eff. 8-9-96; 90-14, eff. 7-1-97; 90-65, eff. 7-7-97; 90-448,
eff. 8-16-97; 90-497, eff. 8-18-97; 90-511, eff. 8-22-97;
90-582, eff. 5-27-98; 90-655, eff. 7-30-98.)
(5 ILCS 375/10) (from Ch. 127, par. 530)
Sec. 10. Payments by State; premiums.
(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 retired members and retired dependents aged
65 years or older who are entitled to 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 retired
members or retired dependents who (1) first become eligible
for such Medicare coverage on or after July 1, 1992; or (2)
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.
(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 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.
(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 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 program of group health benefits shall be the
responsibility of the survivor.
(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 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.
(a-4) (Blank). Beginning January 1, 1998, for each
person who becomes a new SURS retired employee and
participates in the basic program of group health benefits,
the State shall contribute toward the cost of the retired
employee's coverage under the basic program of group health
benefits an amount equal to 5% of that cost for each full
year that the retired employee was an employee as defined in
Section 3, up to a maximum of 100% for a retired employee who
was an employee for 20 or more years. The remainder of the
cost of a new SURS retired employee's coverage under the
basic program of group health benefits shall be the
responsibility of the retired employee.
(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.
(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% for an annuitant with 20 or more years of such
creditable service. 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.
(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 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% for a survivor of an employee or annuitant
with 20 or more years of such creditable service. 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.
(a-8) A new SERS annuitant, new SERS survivor, new SURS
annuitant, new SURS retired employee, 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, 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 or, survivor, or
retired employee may not re-enroll in the program.
(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.
(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 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.
(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.
(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).
(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.
(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 either
the State group health insurance 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 insurance 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 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 85% of the employees are enrolled and the
unit of local government remits the entire cost of providing
coverage to those employees. Employees of a participating
unit of local government who are not enrolled due to coverage
under another group health policy or plan may enroll at a
later date subject to submission of satisfactory evidence of
insurability and provided that no benefits shall be payable
for services incurred during the first 6 months of coverage
to the extent the services are in connection with any
pre-existing condition. 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 insurance 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 insurance or health maintenance
organization coverage shall be deposited in the Local
Government Health Insurance Reserve Fund. The Local
Government Health Insurance Reserve Fund shall be a
continuing fund not subject to fiscal year limitations. 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 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 85% 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 at a later date subject to
submission of satisfactory evidence of insurability and
provided that no benefits shall be payable for services
incurred during the first 6 months of coverage to the extent
the services are in connection with any pre-existing
condition. 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 insurance 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. 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 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 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.
(3) In no case shall the rate be less than the
amount normally charged to State employees or contributed
by the State on behalf of its employees.
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. Those
annuitants enrolled initially under this contract shall have
no benefits payable for services incurred during the first 6
months of coverage to the extent the services are in
connection with any pre-existing condition. Any annuitant
who may enroll after this initial enrollment period shall be
subject to submission of satisfactory evidence of
insurability and to the pre-existing conditions limitation.
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.
(m) The Director shall adopt any rules deemed necessary
for implementation of this amendatory Act of 1989 (Public Act
86-978).
(Source: P.A. 89-53, eff. 7-1-95; 89-236, eff. 8-4-95;
89-324, eff. 8-13-95; 89-626, eff. 8-9-96; 90-65, eff.
7-7-97; 90-582, eff. 5-27-98; 90-655, eff. 7-30-98; revised
8-3-98.)
Section 10. The Illinois Pension Code is amended by
adding Section 15-135.1 as follows:
(40 ILCS 5/15-135.1 new)
Sec. 15-135.1. Election to avoid application of P.A.
90-65.
(a) A participant who was an employee on July 7, 1997
and retires on or after the effective date of this amendatory
Act of the 91st General Assembly may elect in writing at the
time of retirement to have the retirement annuity calculated
in accordance with the provisions of Sections 15-135 and
15-136 as they existed immediately prior to amendment by
Public Act 90-65. This election, once made, is irrevocable.
(b) The fact that a person has elected to participate in
the optional retirement program under Section 15-158.2 or has
elected the portability option under subsection (a-1) of
Section 15-154 does not prevent the person from making an
election under subsection (a) of this Section; the fact that
such a person makes an election under subsection (a) does not
allow the person to change the irrevocable election that he
or she made under Section 15-158.2 or subsection (a-1) of
Section 15-154.
(c) The System shall promptly notify the Department of
Central Management Services of each election made under this
Section.
Section 99. Effective date. This Act takes effect upon
becoming law.
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