Bill Amendment: IL HB4036 | 2019-2020 | 101st General Assembly

NOTE: For additional amemendments please see the Bill Drafting List

---

Bill Title: HEALTH BENEFITS-STATUS CHANGE

Status: 2020-06-23 - Rule 19(b) / Re-referred to Rules Committee [HB4036 Detail]

Download: Illinois-2019-HB4036-House_Amendment_001.html

---

Rep. Sue Scherer

Filed: 3/5/2020

10100HB4036ham001 LRB101 15278 RJF 71144 a
AMENDMENT TO HOUSE BILL 4036
AMENDMENT NO. ______. Amend House Bill 4036 by replacing
everything after the enacting clause with the following:
"Section 5. The State Employees Group Insurance Act of 1971
is amended by changing Sections 3 and 8 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

10100HB4036ham001 - 2 - LRB101 15278 RJF 71144 a
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 (including an employee
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 or who meets the criteria
for retirement, but in lieu of receiving an annuity under that
Article has elected to receive an accelerated pension benefit
payment under Section 14-147.5 of that Article), 15 (including
an employee who has retired under the optional retirement
program established under Section 15-158.2 or who meets the
criteria for retirement but in lieu of receiving an annuity
under that Article has elected to receive an accelerated
pension benefit payment under Section 15-185.5 of the Article),
paragraphs (2), (3), or (5) of Section 16-106 (including an
employee who meets the criteria for retirement, but in lieu of
receiving an annuity under that Article has elected to receive
an accelerated pension benefit payment under Section 16-190.5
of the Illinois Pension Code), 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

10100HB4036ham001 - 3 - LRB101 15278 RJF 71144 a
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, a qualified rehabilitation facility, a qualified
domestic violence shelter or service, or a qualified child
advocacy center. (For definition of "retired employee", see (p)
post).
(b-5) (Blank).
(b-6) (Blank).
(b-7) (Blank).
(c) "Carrier" means (1) an insurance company, a corporation
organized under the Limited Health Service Organization Act or
the Voluntary Health Services Plans 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.

10100HB4036ham001 - 4 - LRB101 15278 RJF 71144 a
(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, qualified rehabilitation facility, qualified
domestic violence shelter or service, or qualified child
advocacy center.
(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 Commission on
Government Forecasting and Accountability as established by
the Legislative Commission Reorganization Act of 1984.

10100HB4036ham001 - 5 - LRB101 15278 RJF 71144 a
(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 Finance Authority.
(h) "Dependent", when the term is used in the context of
the health and life plan, means a member's spouse and any child
(1) from birth to age 26 including an adopted child, a child
who lives with the member from the time of the placement for
adoption until entry of an order of adoption, a stepchild or
adjudicated child, or a child who lives with the member if such

10100HB4036ham001 - 6 - LRB101 15278 RJF 71144 a
member is a court appointed guardian of the child or (2) age 19
or over who has a mental or physical disability from a cause
originating prior to the age of 19 (age 26 if enrolled as an
adult child dependent). For the health plan only, the term
"dependent" also includes (1) 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 income tax deduction purposes and (2) any person
who has received after June 30, 2000 an organ transplant and
who is financially dependent upon the member and eligible to be
claimed as a dependent for income tax purposes. A member
requesting to cover any dependent must provide documentation as
requested by the Department of Central Management Services and
file with the Department any and all forms required by the
Department.
(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

10100HB4036ham001 - 7 - LRB101 15278 RJF 71144 a
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),

10100HB4036ham001 - 8 - LRB101 15278 RJF 71144 a
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 (i) 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, (ii) each employee in the
service of a qualified rehabilitation facility, (iii) each
full-time employee in the service of a qualified domestic
violence shelter or service, and (iv) each full-time employee
in the service of a qualified child advocacy center, as

10100HB4036ham001 - 9 - LRB101 15278 RJF 71144 a
determined according to rules promulgated by the Director.
(l) "Member" means an employee, annuitant, retired
employee or survivor. In the case of an annuitant or retired
employee who first becomes an annuitant or retired employee on
or after January 13, 2012 (the effective date of Public Act
97-668) this amendatory Act of the 97th General Assembly, the
individual must meet the minimum vesting requirements of the
applicable retirement system in order to be eligible for group
insurance benefits under that system. In the case of a survivor
who first becomes a survivor on or after January 13, 2012 (the
effective date of Public Act 97-668) this amendatory Act of the
97th General Assembly, the deceased employee, annuitant, or
retired employee upon whom the annuity is based must have been
eligible to participate in the group insurance system under the
applicable retirement system in order for the survivor to be
eligible for group insurance benefits under that system.
(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 health benefits program offered
by the State of Illinois for persons eligible for the plan.
(p) "Retired employee" means any person who would be an
annuitant as that term is defined herein but for the fact that

10100HB4036ham001 - 10 - LRB101 15278 RJF 71144 a
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.
(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; (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; (3) the surviving dependent of a person who was
an annuitant under this Act by virtue of receiving an
alternative retirement cancellation payment under Section
14-108.5 of the Illinois Pension Code; and (4) a person who
would be receiving an annuity as a survivor of an annuitant
except that the annuitant elected on or after June 4, 2018 to
receive an accelerated pension benefit payment under Section

10100HB4036ham001 - 11 - LRB101 15278 RJF 71144 a
14-147.5, 15-185.5, or 16-190.5 of the Illinois Pension Code in
lieu of receiving an annuity.
(q-2) "SERS" means the State Employees' Retirement System
of Illinois, created under Article 14 of the Illinois Pension
Code.
(q-3) "SURS" means the State Universities Retirement
System, created under Article 15 of the Illinois Pension Code.
(q-4) "TRS" means the Teachers' Retirement System of the
State of Illinois, created under Article 16 of the Illinois
Pension Code.
(q-5) (Blank).
(q-6) (Blank).
(q-7) (Blank).
(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 (including a
combination of school districts under the Intergovernmental
Cooperation Act), 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

10100HB4036ham001 - 12 - LRB101 15278 RJF 71144 a
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; the Southern Illinois
Collegiate Common Market, which is a consortium of higher
education institutions in Southern Illinois; the Illinois
Association of Park Districts; and any hospital provider that
is owned by a county that has 100 or fewer hospital beds and
has not already joined the program. "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

10100HB4036ham001 - 13 - LRB101 15278 RJF 71144 a
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 or
would be receiving such monthly benefit or retirement
annuity except that the benefit recipient elected on or
after June 4, 2018 to receive an accelerated pension
benefit payment under Section 16-190.5 of the Illinois
Pension Code in lieu of receiving an annuity; 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 June 21, 1995 (the effective
date of Public Act 89-25) this amendatory Act of 1995, or
(iv) is a recipient or survivor of a recipient of a

10100HB4036ham001 - 14 - LRB101 15278 RJF 71144 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) natural,
step, adjudicated, or adopted child who is (i) under age
26, (ii) 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 has a mental or physical
disability from a cause originating prior to the age of 19
(age 26 if enrolled as an adult child).
"TRS dependent beneficiary" does not include, as indicated
under paragraph (2) of this subsection (w), a dependent of the
survivor of a TRS benefit recipient who first becomes a
dependent of a survivor of a TRS benefit recipient on or after
January 13, 2012 (the effective date of Public Act 97-668) this
amendatory Act of the 97th General Assembly unless that
dependent would have been eligible for coverage as a dependent
of the deceased TRS benefit recipient upon whom the survivor
benefit is based.
(x) "Military leave" refers to individuals in basic
training for reserves, special/advanced training, annual

10100HB4036ham001 - 15 - LRB101 15278 RJF 71144 a
training, emergency call up, activation by the President of the
United States, or any other training or duty in service to the
United States Armed Forces.
(y) (Blank).
(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 or would be receiving such monthly survivor's annuity
or retirement annuity except that the benefit recipient
elected on or after June 4, 2018 to receive an accelerated
pension benefit payment under Section 15-185.5 of the
Illinois Pension Code in lieu of receiving an annuity; 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

10100HB4036ham001 - 16 - LRB101 15278 RJF 71144 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) natural, step, adjudicated, or adopted
child who is (i) under age 26, or (ii) age 19 or over and
has a mental or physical disability from a cause
originating prior to the age of 19 (age 26 if enrolled as
an adult child).
"Community college dependent beneficiary" does not
include, as indicated under paragraph (2) of this subsection
(aa), a dependent of the survivor of a community college
benefit recipient who first becomes a dependent of a survivor
of a community college benefit recipient on or after January
13, 2012 (the effective date of Public Act 97-668) this
amendatory Act of the 97th General Assembly unless that
dependent would have been eligible for coverage as a dependent
of the deceased community college benefit recipient upon whom
the survivor annuity is based.
(bb) "Qualified child advocacy center" means any Illinois
child advocacy center and its administrative offices funded by
the Department of Children and Family Services, as defined by

10100HB4036ham001 - 17 - LRB101 15278 RJF 71144 a
the Children's Advocacy Center Act (55 ILCS 80/), approved by
the Director and participating in a program created under
subsection (n) of Section 10.
(cc) "Placement for adoption" means the assumption and
retention by a member of a legal obligation for total or
partial support of a child in anticipation of adoption of the
child. The child's placement with the member terminates upon
the termination of such legal obligation.
(dd) "Qualifying change in status" means an event that
effects an individual's eligibility for coverage under a
program of benefits offered under this Act, which may include,
but is not limited to, the following:
(1) events that change an employee's legal marital
status, including marriage, death of spouse, divorce,
legal separation, or annulment;
(2) events that change an employee's number of
dependents, including birth, death, adoption, or placement
for adoption;
(3) events that change the employment status of the
employee, the employee's spouse, or the employee's
dependent, including termination or commencement of
employment, strike or lockout, commencement of or return
from an unpaid leave of absence, change in worksite, or
change in the individual's employment when they cease to be
eligible for the program provided under this Act;
(4) events that cause an employee's dependent to

10100HB4036ham001 - 18 - LRB101 15278 RJF 71144 a
satisfy or cease to satisfy eligibility requirements for
coverage; and
(5) a change of residence for the employee, spouse, or
dependent.
(Source: P.A. 100-355, eff. 1-1-18; 100-587, eff. 6-4-18;
101-242, eff. 8-9-19; revised 9-19-19.)
(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, as defined under this Act and to the extent
permitted in accordance with federal regulations governing
Section 125 of the Internal Revenue Code, special

10100HB4036ham001 - 19 - LRB101 15278 RJF 71144 a
enrollment, special circumstance as defined by the
Director, or during the annual Benefit Choice Period. Any
request to elect dependent coverage due to a qualifying
change in status must be consistent with the change in
status experienced by the member.
(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

10100HB4036ham001 - 20 - LRB101 15278 RJF 71144 a
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

10100HB4036ham001 - 21 - LRB101 15278 RJF 71144 a
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) 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, subject
to the conditions in this subsection.
(1) 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.

10100HB4036ham001 - 22 - LRB101 15278 RJF 71144 a
(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

10100HB4036ham001 - 23 - LRB101 15278 RJF 71144 a
(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

10100HB4036ham001 - 24 - LRB101 15278 RJF 71144 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.)
Section 99. Effective date. This Act takes effect upon
becoming law.".