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92nd General Assembly

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Public Act 92-0862

HB3080 Enrolled                                LRB9207368JSpc

    AN ACT in relation to public employee benefits.

    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 Section 6.5 as follows:

    (5 ILCS 375/6.5)
    Sec.  6.5. Health benefits for TRS benefit recipients and
TRS dependent beneficiaries.
    (a)  Purpose.  It is the purpose of this  amendatory  Act
of  1995  to  transfer  the  administration of the program of
health benefits established for benefit recipients and  their
dependent  beneficiaries  under  Article  16  of the Illinois
Pension  Code  to  the  Department  of   Central   Management
Services.
    (b)  Transition provisions.  The Board of Trustees of the
Teachers'  Retirement System shall continue to administer the
health benefit program established under Article  16  of  the
Illinois  Pension  Code through December 31, 1995.  Beginning
January  1,  1996,  the  Department  of  Central   Management
Services  shall be responsible for administering a program of
health benefits for TRS benefit recipients and TRS  dependent
beneficiaries  under this Section.  The Department of Central
Management Services and the Teachers' Retirement System shall
cooperate  in  this  endeavor  and  shall  coordinate   their
activities   so   as   to  ensure  a  smooth  transition  and
uninterrupted health benefit coverage.
    (c)  Eligibility.  All persons who were enrolled  in  the
Article  16  program  at  the  time  of the transfer shall be
eligible to participate in the program established under this
Section without any interruption  or  delay  in  coverage  or
limitation    as    to   pre-existing   medical   conditions.
Eligibility  to  participate  shall  be  determined  by   the
Teachers'  Retirement  System.  Eligibility information shall
be communicated  to  the  Department  of  Central  Management
Services in a format acceptable to the Department.
    A TRS dependent beneficiary who is an unmarried child age
19  or  over  and mentally or physically handicapped does not
become ineligible to participate by reason  of  (i)  becoming
ineligible  to  be  claimed  as  a  dependent for Illinois or
federal income tax purposes or (ii) receiving earned  income,
so  long  as those earnings are insufficient for the child to
be fully self-sufficient.
    (d)  Coverage.  The level  of  health  benefits  provided
under  this Section shall be similar to the level of benefits
provided by the program previously established under  Article
16 of the Illinois Pension Code.
      Group  life  insurance benefits are not included in the
benefits to be provided to TRS  benefit  recipients  and  TRS
dependent beneficiaries under this Act.
    The  program  of  health  benefits under this Section may
include any or all of the benefit limitations, including  but
not  limited  to a reduction in benefits based on eligibility
for  federal  medicare  benefits,  that  are  provided  under
subsection (a) of Section 6 of  this  Act  for  other  health
benefit programs under this Act.
    (e)  Insurance  rates  and  premiums.  The Director shall
determine the insurance rates and premiums  for  TRS  benefit
recipients  and TRS dependent beneficiaries.  For Fiscal Year
1996, the premium shall be  equal  to  the  premium  actually
charged  in  Fiscal  Year  1995.   In  subsequent  years, the
premium shall never be lower  than  the  premium  charged  in
Fiscal Year 1995.
    Rates  and  premiums  may  be  based  in  part on age and
eligibility for federal medicare coverage.  However, the cost
of participation for a TRS dependent beneficiary  who  is  an
unmarried  child  age  19  or over and mentally or physically
handicapped shall not exceed the cost  for  a  TRS  dependent
beneficiary  who  is  an  unmarried  child  under  age 19 and
participates in  the  same  major  medical  or  managed  care
program.
    The  cost  of  health benefits under the program shall be
paid as follows:
         (1)  For a TRS benefit recipient selecting a managed
    care program, up to 75% of the total insurance rate shall
    be paid from the Teacher Health Insurance Security Fund.
         (2)  For a TRS benefit recipient selecting the major
    medical  coverage  program,  up  to  50%  of  the   total
    insurance  rate  shall  be  paid  from the Teacher Health
    Insurance Security Fund if  a  managed  care  program  is
    accessible,  as  determined  by  the Teachers' Retirement
    System.
         (3)  For a TRS benefit recipient selecting the major
    medical  coverage  program,  up  to  75%  of  the   total
    insurance  rate  shall  be  paid  from the Teacher Health
    Insurance Security Fund if a managed care program is  not
    accessible,  as  determined  by  the Teachers' Retirement
    System.
         (4)  The balance of the rate of insurance, including
    the entire premium of  any  coverage  for  TRS  dependent
    beneficiaries  that  has  been  elected, shall be paid by
    deductions authorized by the TRS benefit recipient to  be
    withheld  from  his  or  her  monthly  annuity or benefit
    payment from the Teachers' Retirement System; except that
    (i) if the balance of the cost of  coverage  exceeds  the
    amount  of  the  monthly  annuity or benefit payment, the
    difference  shall  be  paid  directly  to  the  Teachers'
    Retirement System by the TRS benefit recipient, and  (ii)
    all  or  part of the balance of the cost of coverage may,
    at the school  board's option, be paid to  the  Teachers'
    Retirement  System  by  the  school  board  of the school
    district from which the TRS benefit recipient retired, in
    accordance with Section 10-22.3b of the School Code.  The
    Teachers' Retirement System shall  promptly  deposit  all
    moneys  withheld  by or paid to it under this subdivision
    (e)(4) into the Teacher Health Insurance  Security  Fund.
    These  moneys  shall  not  be  considered  assets  of the
    Retirement System.
    (f)  Financing.  Beginning July  1,  1995,  all  revenues
arising   from  the  administration  of  the  health  benefit
programs established under Article 16 of the Illinois Pension
Code or this Section shall  be  deposited  into  the  Teacher
Health  Insurance Security Fund, which is hereby created as a
nonappropriated trust fund  to  be  held  outside  the  State
Treasury,   with  the  State  Treasurer  as  custodian.   Any
interest earned on moneys in  the  Teacher  Health  Insurance
Security Fund shall be deposited into the Fund.
    Moneys  in  the  Teacher  Health  Insurance Security Fund
shall be used only to pay the costs  of  the  health  benefit
program  established under this Section, including associated
administrative costs,  and  the  costs  associated  with  the
health  benefit  program  established under Article 16 of the
Illinois  Pension  Code,  as  authorized  in  this   Section.
Beginning  July 1, 1995, the Department of Central Management
Services  may  make  expenditures  from  the  Teacher  Health
Insurance Security Fund for those costs.
    After other funds authorized for the payment of the costs
of the health benefit program established under Article 16 of
the Illinois Pension Code are exhausted and until January  1,
1996  (or  such  later  date  as  may  be  agreed upon by the
Director of Central Management Services and the Secretary  of
the  Teachers'  Retirement  System),  the  Secretary  of  the
Teachers'  Retirement  System  may make expenditures from the
Teacher Health Insurance Security Fund as necessary to pay up
to 75% of the cost of providing health coverage  to  eligible
benefit  recipients  (as  defined  in  Sections  16-153.1 and
16-153.3 of the Illinois Pension Code) who  are  enrolled  in
the  Article  16 health benefit program and to facilitate the
transfer of administration of the health benefit  program  to
the Department of Central Management Services.
    (g)  Contract   for  benefits.   The  Director  shall  by
contract, self-insurance, or  otherwise  make  available  the
program  of  health  benefits  for TRS benefit recipients and
their TRS dependent beneficiaries that  is  provided  for  in
this  Section.   The  contract  or  other arrangement for the
provision of these health benefits shall be on  terms  deemed
by  the  Director  to be in the best interest of the State of
Illinois and the TRS benefit recipients  based  on,  but  not
limited  to,  such  criteria  as administrative cost, service
capabilities of the carrier  or  other  contractor,  and  the
costs of the benefits.
    (h)  Continuation of program.  It is the intention of the
General Assembly that the program of health benefits provided
under  this  Section  be maintained on an ongoing, affordable
basis.  The program of health benefits  provided  under  this
Section may be amended by the State and is not intended to be
a  pension  or retirement benefit subject to protection under
Article XIII, Section 5 of the Illinois Constitution.
(Source: P.A. 89-21, eff. 6-21-95; 89-25, eff. 6-21-95.)

    Section 99. Effective date.  This Act takes  effect  upon
becoming law.
    Passed in the General Assembly December 04, 2002.
    Approved January 03, 2003.

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