Bill Text: IL HB6290 | 2013-2014 | 98th General Assembly | Introduced
Bill Title: Amends the State Employees Group Insurance Act of 1971. Provides that, on and after the effective date of the amendatory Act, the State shall not pay or otherwise make contributions toward the costs of any health or life insurance benefits provided under the Act for retired elected officials under the General Assembly Retirement System. Provides that retired elected officials shall pay the entirety of the cost of coverage under the group life insurance program and the program of health benefits under the Act; provides that the cost of coverage shall be determined by the Director. Provides that nothing in the amendatory Act shall be construed to prevent any retired elected official from receiving health or life insurance benefits under the Act, where that retired elected official contributes the entirety of the cost of coverage. Provides that any retired elected official may waive or terminate coverage in the program of health benefits or group life insurance. Further provides that any retired elected official who has waived or terminated coverage may enroll or re-enroll in the program of health benefits or group life insurance 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 retired elected official may not re-enroll in the program. Makes corresponding changes throughout the Act. Defines "retired elected official". Effective immediately.
Spectrum: Partisan Bill (Democrat 11-0)
Status: (Failed) 2014-12-03 - Session Sine Die [HB6290 Detail]
Download: Illinois-2013-HB6290-Introduced.html
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1 | AN ACT concerning government.
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2 | Be it enacted by the People of the State of Illinois,
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3 | represented in the General Assembly:
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4 | Section 5. The State Employees Group Insurance Act of 1971 | ||||||||||||||||||||||||||||||
5 | is amended by changing Sections 6, 7, and 10 and by adding | ||||||||||||||||||||||||||||||
6 | Section 10.5 as follows:
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7 | (5 ILCS 375/6) (from Ch. 127, par. 526)
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8 | Sec. 6. Program of health benefits.
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9 | (a) The program of health benefits shall provide for | ||||||||||||||||||||||||||||||
10 | protection
against the financial costs of health care expenses | ||||||||||||||||||||||||||||||
11 | incurred in and out
of hospital including basic | ||||||||||||||||||||||||||||||
12 | hospital-surgical-medical coverages. The program
may include, | ||||||||||||||||||||||||||||||
13 | but shall not be limited to, such supplemental coverages as
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14 | out-patient diagnostic X-ray and laboratory expenses, | ||||||||||||||||||||||||||||||
15 | prescription drugs,
dental services, hearing evaluations, | ||||||||||||||||||||||||||||||
16 | hearing aids, the dispensing and
fitting
of hearing aids, and | ||||||||||||||||||||||||||||||
17 | similar group benefits
as are now or may become available. | ||||||||||||||||||||||||||||||
18 | However, nothing in this Act shall
be construed to permit, on | ||||||||||||||||||||||||||||||
19 | or after July 1, 1980, the non-contributory portion
of any such | ||||||||||||||||||||||||||||||
20 | program to include the expenses of obtaining an abortion, | ||||||||||||||||||||||||||||||
21 | induced
miscarriage or induced premature birth unless, in the | ||||||||||||||||||||||||||||||
22 | opinion of a physician,
such procedures are necessary for the | ||||||||||||||||||||||||||||||
23 | preservation of the life of the woman
seeking such treatment, |
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1 | or except an induced premature birth intended to
produce a live | ||||||
2 | viable child and such procedure is necessary for the health
of | ||||||
3 | the mother or the unborn child. The program may also include
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4 | coverage for those who rely on treatment by prayer or spiritual | ||||||
5 | means
alone for healing in accordance with the tenets and | ||||||
6 | practice of a
recognized religious denomination.
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7 | The program of health benefits shall be designed by the | ||||||
8 | Director
(1) to provide a reasonable relationship between the | ||||||
9 | benefits to be
included and the expected distribution of | ||||||
10 | expenses of each such type to
be incurred by the covered | ||||||
11 | members and dependents,
(2) to specify, as covered benefits and | ||||||
12 | as optional benefits, the
medical services of practitioners in | ||||||
13 | all categories licensed under the
Medical Practice Act of 1987, | ||||||
14 | (3) to include
reasonable controls, which may include | ||||||
15 | deductible and co-insurance
provisions, applicable to some or | ||||||
16 | all of the benefits, or a coordination
of benefits provision, | ||||||
17 | to prevent or minimize unnecessary utilization of
the various | ||||||
18 | hospital, surgical and medical expenses to be provided and
to | ||||||
19 | provide reasonable assurance of stability of the program, and | ||||||
20 | (4) to
provide benefits to the extent possible to members | ||||||
21 | throughout the
State, wherever located, on an equitable basis.
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22 | Notwithstanding any other provision of this Section or Act,
for | ||||||
23 | all members or dependents who are eligible for benefits under | ||||||
24 | Social
Security or the
Railroad Retirement system or who had | ||||||
25 | sufficient Medicare-covered government
employment,
the
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26 | Department shall reduce benefits
which would otherwise be paid |
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1 | by Medicare, by the amount of benefits for
which the member or | ||||||
2 | dependents are eligible
under Medicare, except that such | ||||||
3 | reduction in benefits shall apply only to
those members or | ||||||
4 | dependents who (1) first become
eligible for such medicare | ||||||
5 | coverage on or after the effective date of this
amendatory Act | ||||||
6 | of 1992; or (2) are Medicare-eligible members or dependents of
| ||||||
7 | a local government unit which began participation in the | ||||||
8 | program on or after
July 1, 1992; or (3) remain eligible for | ||||||
9 | but no longer receive
Medicare coverage which they had been | ||||||
10 | receiving on or after the effective date
of this amendatory Act | ||||||
11 | of 1992.
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12 | Notwithstanding any other provisions of this Act, where a | ||||||
13 | covered member or
dependents are eligible for benefits under | ||||||
14 | the federal Medicare health
insurance program (Title XVIII of | ||||||
15 | the Social Security Act as added by
Public Law 89-97, 89th | ||||||
16 | Congress), benefits paid under the State of Illinois
program or | ||||||
17 | plan will be reduced by the amount of benefits paid by | ||||||
18 | Medicare.
For members or dependents
who are eligible for | ||||||
19 | benefits under Social Security
or the Railroad Retirement | ||||||
20 | system or who had sufficient Medicare-covered
government | ||||||
21 | employment, benefits shall be reduced by the amount for which
| ||||||
22 | the member or dependent is eligible under Medicare,
except that | ||||||
23 | such reduction in benefits shall apply only to those
members or | ||||||
24 | dependents who (1) first become eligible for such
Medicare | ||||||
25 | coverage on or after the effective date of this amendatory Act
| ||||||
26 | of 1992; or (2) are Medicare-eligible members or dependents of |
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1 | a local
government unit which began participation in the | ||||||
2 | program on or after July 1,
1992; or (3) remain eligible for, | ||||||
3 | but no longer receive Medicare
coverage which they had been | ||||||
4 | receiving on or after the effective date of this
amendatory Act | ||||||
5 | of 1992. Premiums may be adjusted, where applicable, to an
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6 | amount deemed by the Director to be reasonably consistent with | ||||||
7 | any reduction
of benefits.
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8 | (b) (Blank). A member, not otherwise covered by this Act, | ||||||
9 | who has retired as a
participating member under Article 2 of | ||||||
10 | the Illinois Pension Code
but is ineligible for the retirement | ||||||
11 | annuity under Section 2-119 of the
Illinois
Pension Code, shall | ||||||
12 | pay the premiums for coverage, not
exceeding the amount paid by | ||||||
13 | the State for the non-contributory coverage for
other members, | ||||||
14 | under the group health benefits program under this Act. The
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15 | Director shall determine the premiums to be paid
by a member | ||||||
16 | under this subsection (b).
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17 | (Source: P.A. 93-47, eff. 7-1-03.)
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18 | (5 ILCS 375/7) (from Ch. 127, par. 527)
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19 | Sec. 7. Group life insurance program.
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20 | (a) The basic noncontributory group life insurance program | ||||||
21 | shall
provide coverage as follows:
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22 | (1) employees shall be insured in an amount equal to | ||||||
23 | the basic annual
salary rate, exclusive of overtime, bonus, | ||||||
24 | or other cumulative additional
income factors, raised to | ||||||
25 | the next round hundred dollar
amount if it is not already a |
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1 | round hundred dollar amount;
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2 | (2) annuitants shall be insured in the same manner as | ||||||
3 | described for
active employees, based on the salary in | ||||||
4 | force immediately before
retirement, with coverage | ||||||
5 | becoming effective on the effective date of
retirement | ||||||
6 | benefits or the first day of the month of application, | ||||||
7 | whichever
occurs later, except that at age 60 the amount of | ||||||
8 | coverage for the
annuitant shall be reduced to $5,000;
| ||||||
9 | (3) survivors whose coverage became effective prior to | ||||||
10 | September 22,
1979 shall be insured for $2,000;
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11 | (4) retired employees shall not be eligible under the | ||||||
12 | group life insurance
program contracted to begin or | ||||||
13 | continue after June 30, 1973.
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14 | (a-5) There shall also be available on an optional basis to | ||||||
15 | employees,
annuitants whose retirement benefits begin within | ||||||
16 | one year of their receipt of
final compensation, and survivors | ||||||
17 | whose coverage became effective prior to
September 22, 1979, a | ||||||
18 | contributory program of:
| ||||||
19 | (1) supplemental life insurance in an amount not | ||||||
20 | exceeding 8 times the
basic life benefits for active | ||||||
21 | employees and annuitants under age 60 and not exceeding 4 | ||||||
22 | times the basic life benefits for annuitants age 60 and | ||||||
23 | over, as described above, except that (a) amounts selected
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24 | by employees and annuitants must be in full multiples of | ||||||
25 | the basic amount,
and (b) premiums may be adjusted by age | ||||||
26 | bracket established in rules
supplementing this Act; |
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| |||||||
1 | beginning July 1, 1981, survivors whose coverage
becomes | ||||||
2 | effective on or after September 22, 1979, shall have the | ||||||
3 | option of
participating in the contributory program of life | ||||||
4 | insurance in an amount of
$5,000 coverage;
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5 | (2) accidental death and dismemberment, with the | ||||||
6 | employee and annuitant
having the option of electing an | ||||||
7 | amount equal to the basic noncontributory
life benefits | ||||||
8 | only, or an amount equaling the combined total of basic | ||||||
9 | plus
optional life benefits not exceeding 5 times basic | ||||||
10 | life benefits, or $3,000,000, whichever is less;
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11 | (3) dependent life insurance in an amount of $10,000 | ||||||
12 | coverage on the
spouse; however, coverage reduces to $5,000 | ||||||
13 | when the eligible annuitant turns 60; and
| ||||||
14 | (4) dependent life insurance in an amount of $10,000
| ||||||
15 | coverage on each
dependent other than the spouse.
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16 | (b) (Blank). A member, not otherwise covered by this Act, | ||||||
17 | who has retired as a
participating member under Article 2 of | ||||||
18 | the Illinois Pension
Code, but is ineligible for the retirement | ||||||
19 | annuity under Section 2-119
of the Illinois Pension Code, shall | ||||||
20 | pay the premiums for coverage under
the group life insurance | ||||||
21 | program under this Act. The Director shall promulgate
rules and | ||||||
22 | regulations to determine the premiums to be paid by a member
| ||||||
23 | under this subsection (b).
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24 | (Source: P.A. 94-95, eff. 7-1-05.)
| ||||||
25 | (5 ILCS 375/10) (from Ch. 127, par. 530)
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1 | Sec. 10. Contributions by the State and members.
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2 | (a) Except as otherwise provided in Section 10.5 of this | ||||||
3 | Act, the The State shall pay the cost of basic non-contributory | ||||||
4 | group life
insurance and, subject to member paid contributions | ||||||
5 | set by the Department or
required by this Section and except as | ||||||
6 | provided in this Section, the basic program of group health | ||||||
7 | benefits on each
eligible member, except a member, not | ||||||
8 | otherwise
covered by this Act, who has retired as a | ||||||
9 | participating member under Article 2
of the Illinois Pension | ||||||
10 | Code but is ineligible for the retirement annuity under
Section | ||||||
11 | 2-119 of the Illinois Pension Code, and part of each eligible | ||||||
12 | member's
and retired member's premiums for health insurance | ||||||
13 | coverage for enrolled
dependents as provided by Section 9. The | ||||||
14 | State shall pay the cost of the basic
program of group health | ||||||
15 | benefits only after benefits are reduced by the amount
of | ||||||
16 | benefits covered by Medicare for all members and dependents
who | ||||||
17 | are eligible for benefits under Social Security or
the Railroad | ||||||
18 | Retirement system or who had sufficient Medicare-covered
| ||||||
19 | government employment, except that such reduction in benefits | ||||||
20 | shall apply only
to those members and dependents who (1) first | ||||||
21 | become eligible
for such Medicare coverage on or after July 1, | ||||||
22 | 1992; or (2) are
Medicare-eligible members or dependents of a | ||||||
23 | local government unit which began
participation in the program | ||||||
24 | on or after July 1, 1992; or (3) remain eligible
for, but no | ||||||
25 | longer receive Medicare coverage which they had been receiving | ||||||
26 | on
or after July 1, 1992. The Department may determine the |
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| |||||||
1 | aggregate level of the
State's contribution on the basis of | ||||||
2 | actual cost of medical services adjusted
for age, sex or | ||||||
3 | geographic or other demographic characteristics which affect
| ||||||
4 | the costs of such programs.
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5 | The cost of participation in the basic program of group | ||||||
6 | health benefits
for the dependent or survivor of a living or | ||||||
7 | deceased retired employee who was
formerly employed by the | ||||||
8 | University of Illinois in the Cooperative Extension
Service and | ||||||
9 | would be an annuitant but for the fact that he or she was made
| ||||||
10 | ineligible to participate in the State Universities Retirement | ||||||
11 | System by clause
(4) of subsection (a) of Section 15-107 of the | ||||||
12 | Illinois Pension Code shall not
be greater than the cost of | ||||||
13 | participation that would otherwise apply to that
dependent or | ||||||
14 | survivor if he or she were the dependent or survivor of an
| ||||||
15 | annuitant under the State Universities Retirement System.
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16 | (a-1) (Blank).
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17 | (a-2) (Blank).
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18 | (a-3) (Blank).
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19 | (a-4) (Blank).
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20 | (a-5) (Blank).
| ||||||
21 | (a-6) (Blank).
| ||||||
22 | (a-7) (Blank).
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23 | (a-8) Any annuitant, survivor, or retired employee may | ||||||
24 | waive or terminate coverage in
the program of group health | ||||||
25 | benefits. Any such annuitant, survivor, or retired employee
who | ||||||
26 | has waived or terminated coverage may enroll or re-enroll in |
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1 | the
program of group health benefits only during the annual | ||||||
2 | benefit choice period,
as determined by the Director; except | ||||||
3 | that in the event of termination of
coverage due to nonpayment | ||||||
4 | of premiums, the annuitant, survivor, or retired employee
may | ||||||
5 | not re-enroll in the program.
| ||||||
6 | (a-8.5) Beginning on the effective date of this amendatory | ||||||
7 | Act of the 97th General Assembly, the Director of Central | ||||||
8 | Management Services shall, on an annual basis, determine the | ||||||
9 | amount that the State shall contribute toward the basic program | ||||||
10 | of group health benefits on behalf of annuitants (including | ||||||
11 | individuals who (i) participated in the General Assembly | ||||||
12 | Retirement System, the State Employees' Retirement System of | ||||||
13 | Illinois, the State Universities Retirement System, the | ||||||
14 | Teachers' Retirement System of the State of Illinois, or the | ||||||
15 | Judges Retirement System of Illinois and (ii) qualify as | ||||||
16 | annuitants under subsection (b) of Section 3 of this Act), | ||||||
17 | survivors (including individuals who (i) receive an annuity as | ||||||
18 | a survivor of an individual who participated in the General | ||||||
19 | Assembly Retirement System, the State Employees' Retirement | ||||||
20 | System of Illinois, the State Universities Retirement System, | ||||||
21 | the Teachers' Retirement System of the State of Illinois, or | ||||||
22 | the Judges Retirement System of Illinois and (ii) qualify as | ||||||
23 | survivors under subsection (q) of Section 3 of this Act), and | ||||||
24 | retired employees (as defined in subsection (p) of Section 3 of | ||||||
25 | this Act). The remainder of the cost of coverage for each | ||||||
26 | annuitant, survivor, or retired employee, as determined by the |
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1 | Director of Central Management Services, shall be the | ||||||
2 | responsibility of that annuitant, survivor, or retired | ||||||
3 | employee. | ||||||
4 | Except as otherwise provided in Section 10.5 of this Act, | ||||||
5 | contributions Contributions required of annuitants, survivors, | ||||||
6 | and retired employees shall be the same for all retirement | ||||||
7 | systems and shall also be based on whether an individual has | ||||||
8 | made an election under Section 15-135.1 of the Illinois Pension | ||||||
9 | Code. Contributions may be based on annuitants', survivors', or | ||||||
10 | retired employees' Medicare eligibility, but may not be based | ||||||
11 | on Social Security eligibility. | ||||||
12 | (a-9) No later than May 1 of each calendar year, the | ||||||
13 | Director
of Central Management Services shall certify in | ||||||
14 | writing to the Executive
Secretary of the State Employees' | ||||||
15 | Retirement System of Illinois the amounts
of the Medicare | ||||||
16 | supplement health care premiums and the amounts of the
health | ||||||
17 | care premiums for all other retirees who are not Medicare | ||||||
18 | eligible.
| ||||||
19 | A separate calculation of the premiums based upon the | ||||||
20 | actual cost of each
health care plan shall be so certified.
| ||||||
21 | The Director of Central Management Services shall provide | ||||||
22 | to the
Executive Secretary of the State Employees' Retirement | ||||||
23 | System of
Illinois such information, statistics, and other data | ||||||
24 | as he or she
may require to review the premium amounts | ||||||
25 | certified by the Director
of Central Management Services.
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26 | The Department of Central Management Services, or any |
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1 | successor agency designated to procure healthcare contracts | ||||||
2 | pursuant to this Act, is authorized to establish funds, | ||||||
3 | separate accounts provided by any bank or banks as defined by | ||||||
4 | the Illinois Banking Act, or separate accounts provided by any | ||||||
5 | savings and loan association or associations as defined by the | ||||||
6 | Illinois Savings and Loan Act of 1985 to be held by the | ||||||
7 | Director, outside the State treasury, for the purpose of | ||||||
8 | receiving the transfer of moneys from the Local Government | ||||||
9 | Health Insurance Reserve Fund. The Department may promulgate | ||||||
10 | rules further defining the methodology for the transfers. Any | ||||||
11 | interest earned by moneys in the funds or accounts shall inure | ||||||
12 | to the Local Government Health Insurance Reserve Fund. The | ||||||
13 | transferred moneys, and interest accrued thereon, shall be used | ||||||
14 | exclusively for transfers to administrative service | ||||||
15 | organizations or their financial institutions for payments of | ||||||
16 | claims to claimants and providers under the self-insurance | ||||||
17 | health plan. The transferred moneys, and interest accrued | ||||||
18 | thereon, shall not be used for any other purpose including, but | ||||||
19 | not limited to, reimbursement of administration fees due the | ||||||
20 | administrative service organization pursuant to its contract | ||||||
21 | or contracts with the Department.
| ||||||
22 | (b) State employees who become eligible for this program on | ||||||
23 | or after January
1, 1980 in positions normally requiring actual | ||||||
24 | performance of duty not less
than 1/2 of a normal work period | ||||||
25 | but not equal to that of a normal work period,
shall be given | ||||||
26 | the option of participating in the available program. If the
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1 | employee elects coverage, the State shall contribute on behalf | ||||||
2 | of such employee
to the cost of the employee's benefit and any | ||||||
3 | applicable dependent supplement,
that sum which bears the same | ||||||
4 | percentage as that percentage of time the
employee regularly | ||||||
5 | works when compared to normal work period.
| ||||||
6 | (c) The basic non-contributory coverage from the basic | ||||||
7 | program of
group health benefits shall be continued for each | ||||||
8 | employee not in pay status or
on active service by reason of | ||||||
9 | (1) leave of absence due to illness or injury,
(2) authorized | ||||||
10 | educational leave of absence or sabbatical leave, or (3)
| ||||||
11 | military leave. This coverage shall continue until
expiration | ||||||
12 | of authorized leave and return to active service, but not to | ||||||
13 | exceed
24 months for leaves under item (1) or (2). This | ||||||
14 | 24-month limitation and the
requirement of returning to active | ||||||
15 | service shall not apply to persons receiving
ordinary or | ||||||
16 | accidental disability benefits or retirement benefits through | ||||||
17 | the
appropriate State retirement system or benefits under the | ||||||
18 | Workers' Compensation
or Occupational Disease Act.
| ||||||
19 | (d) The basic group life insurance coverage shall continue, | ||||||
20 | with
full State contribution, where such person is (1) absent | ||||||
21 | from active
service by reason of disability arising from any | ||||||
22 | cause other than
self-inflicted, (2) on authorized educational | ||||||
23 | leave of absence or
sabbatical leave, or (3) on military leave.
| ||||||
24 | (e) Where the person is in non-pay status for a period in | ||||||
25 | excess of
30 days or on leave of absence, other than by reason | ||||||
26 | of disability,
educational or sabbatical leave, or military |
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| |||||||
1 | leave, such
person may continue coverage only by making | ||||||
2 | personal
payment equal to the amount normally contributed by | ||||||
3 | the State on such person's
behalf. Such payments and coverage | ||||||
4 | may be continued: (1) until such time as
the person returns to | ||||||
5 | a status eligible for coverage at State expense, but not
to | ||||||
6 | exceed 24 months or (2) until such person's employment or | ||||||
7 | annuitant status
with the State is terminated (exclusive of any | ||||||
8 | additional service imposed pursuant to law).
| ||||||
9 | (f) The Department shall establish by rule the extent to | ||||||
10 | which other
employee benefits will continue for persons in | ||||||
11 | non-pay status or who are
not in active service.
| ||||||
12 | (g) The State shall not pay the cost of the basic | ||||||
13 | non-contributory
group life insurance, program of health | ||||||
14 | benefits and other employee benefits
for members who are | ||||||
15 | survivors as defined by paragraphs (1) and (2) of
subsection | ||||||
16 | (q) of Section 3 of this Act. The costs of benefits for these
| ||||||
17 | survivors shall be paid by the survivors or by the University | ||||||
18 | of Illinois
Cooperative Extension Service, or any combination | ||||||
19 | thereof.
However, the State shall pay the amount of the | ||||||
20 | reduction in the cost of
participation, if any, resulting from | ||||||
21 | the amendment to subsection (a) made
by this amendatory Act of | ||||||
22 | the 91st General Assembly.
| ||||||
23 | (h) Those persons occupying positions with any department | ||||||
24 | as a result
of emergency appointments pursuant to Section 8b.8 | ||||||
25 | of the Personnel Code
who are not considered employees under | ||||||
26 | this Act shall be given the option
of participating in the |
| |||||||
| |||||||
1 | programs of group life insurance, health benefits and
other | ||||||
2 | employee benefits. Such persons electing coverage may | ||||||
3 | participate only
by making payment equal to the amount normally | ||||||
4 | contributed by the State for
similarly situated employees. Such | ||||||
5 | amounts shall be determined by the
Director. Such payments and | ||||||
6 | coverage may be continued until such time as the
person becomes | ||||||
7 | an employee pursuant to this Act or such person's appointment | ||||||
8 | is
terminated.
| ||||||
9 | (i) Any unit of local government within the State of | ||||||
10 | Illinois
may apply to the Director to have its employees, | ||||||
11 | annuitants, and their
dependents provided group health | ||||||
12 | coverage under this Act on a non-insured
basis. To participate, | ||||||
13 | a unit of local government must agree to enroll
all of its | ||||||
14 | employees, who may select coverage under either the State group
| ||||||
15 | health benefits plan or a health maintenance organization that | ||||||
16 | has
contracted with the State to be available as a health care | ||||||
17 | provider for
employees as defined in this Act. A unit of local | ||||||
18 | government must remit the
entire cost of providing coverage | ||||||
19 | under the State group health benefits plan
or, for coverage | ||||||
20 | under a health maintenance organization, an amount determined
| ||||||
21 | by the Director based on an analysis of the sex, age, | ||||||
22 | geographic location, or
other relevant demographic variables | ||||||
23 | for its employees, except that the unit of
local government | ||||||
24 | shall not be required to enroll those of its employees who are
| ||||||
25 | covered spouses or dependents under this plan or another group | ||||||
26 | policy or plan
providing health benefits as long as (1) an |
| |||||||
| |||||||
1 | appropriate official from the unit
of local government attests | ||||||
2 | that each employee not enrolled is a covered spouse
or | ||||||
3 | dependent under this plan or another group policy or plan, and | ||||||
4 | (2) at least
50% of the employees are enrolled and the unit of | ||||||
5 | local government remits
the entire cost of providing coverage | ||||||
6 | to those employees, except that a
participating school district | ||||||
7 | must have enrolled at least 50% of its full-time
employees who | ||||||
8 | have not waived coverage under the district's group health
plan | ||||||
9 | by participating in a component of the district's cafeteria | ||||||
10 | plan. A
participating school district is not required to enroll | ||||||
11 | a full-time employee
who has waived coverage under the | ||||||
12 | district's health plan, provided that an
appropriate official | ||||||
13 | from the participating school district attests that the
| ||||||
14 | full-time employee has waived coverage by participating in a | ||||||
15 | component of the
district's cafeteria plan. For the purposes of | ||||||
16 | this subsection, "participating
school district" includes a | ||||||
17 | unit of local government whose primary purpose is
education as | ||||||
18 | defined by the Department's rules.
| ||||||
19 | Employees of a participating unit of local government who | ||||||
20 | are not enrolled
due to coverage under another group health | ||||||
21 | policy or plan may enroll in
the event of a qualifying change | ||||||
22 | in status, special enrollment, special
circumstance as defined | ||||||
23 | by the Director, or during the annual Benefit Choice
Period. A | ||||||
24 | participating unit of local government may also elect to cover | ||||||
25 | its
annuitants. Dependent coverage shall be offered on an | ||||||
26 | optional basis, with the
costs paid by the unit of local |
| |||||||
| |||||||
1 | government, its employees, or some combination
of the two as | ||||||
2 | determined by the unit of local government. The unit of local
| ||||||
3 | government shall be responsible for timely collection and | ||||||
4 | transmission of
dependent premiums.
| ||||||
5 | The Director shall annually determine monthly rates of | ||||||
6 | payment, subject
to the following constraints:
| ||||||
7 | (1) In the first year of coverage, the rates shall be | ||||||
8 | equal to the
amount normally charged to State employees for | ||||||
9 | elected optional coverages
or for enrolled dependents | ||||||
10 | coverages or other contributory coverages, or
contributed | ||||||
11 | by the State for basic insurance coverages on behalf of its
| ||||||
12 | employees, adjusted for differences between State | ||||||
13 | employees and employees
of the local government in age, | ||||||
14 | sex, geographic location or other relevant
demographic | ||||||
15 | variables, plus an amount sufficient to pay for the | ||||||
16 | additional
administrative costs of providing coverage to | ||||||
17 | employees of the unit of
local government and their | ||||||
18 | dependents.
| ||||||
19 | (2) In subsequent years, a further adjustment shall be | ||||||
20 | made to reflect
the actual prior years' claims experience | ||||||
21 | of the employees of the unit of
local government.
| ||||||
22 | In the case of coverage of local government employees under | ||||||
23 | a health
maintenance organization, the Director shall annually | ||||||
24 | determine for each
participating unit of local government the | ||||||
25 | maximum monthly amount the unit
may contribute toward that | ||||||
26 | coverage, based on an analysis of (i) the age,
sex, geographic |
| |||||||
| |||||||
1 | location, and other relevant demographic variables of the
| ||||||
2 | unit's employees and (ii) the cost to cover those employees | ||||||
3 | under the State
group health benefits plan. The Director may | ||||||
4 | similarly determine the
maximum monthly amount each unit of | ||||||
5 | local government may contribute toward
coverage of its | ||||||
6 | employees' dependents under a health maintenance organization.
| ||||||
7 | Monthly payments by the unit of local government or its | ||||||
8 | employees for
group health benefits plan or health maintenance | ||||||
9 | organization coverage shall
be deposited in the Local | ||||||
10 | Government Health Insurance Reserve Fund.
| ||||||
11 | The Local Government Health Insurance Reserve Fund is | ||||||
12 | hereby created as a nonappropriated trust fund to be held | ||||||
13 | outside the State Treasury, with the State Treasurer as | ||||||
14 | custodian. The Local Government Health Insurance Reserve Fund | ||||||
15 | shall be a continuing
fund not subject to fiscal year | ||||||
16 | limitations. The Local Government Health Insurance Reserve | ||||||
17 | Fund is not subject to administrative charges or charge-backs, | ||||||
18 | including but not limited to those authorized under Section 8h | ||||||
19 | of the State Finance Act. All revenues arising from the | ||||||
20 | administration of the health benefits program established | ||||||
21 | under this Section shall be deposited into the Local Government | ||||||
22 | Health Insurance Reserve Fund. Any interest earned on moneys in | ||||||
23 | the Local Government Health Insurance Reserve Fund shall be | ||||||
24 | deposited into the Fund. All expenditures from this Fund
shall | ||||||
25 | be used for payments for health care benefits for local | ||||||
26 | government and rehabilitation facility
employees, annuitants, |
| |||||||
| |||||||
1 | and dependents, and to reimburse the Department or
its | ||||||
2 | administrative service organization for all expenses incurred | ||||||
3 | in the
administration of benefits. No other State funds may be | ||||||
4 | used for these
purposes.
| ||||||
5 | A local government employer's participation or desire to | ||||||
6 | participate
in a program created under this subsection shall | ||||||
7 | not limit that employer's
duty to bargain with the | ||||||
8 | representative of any collective bargaining unit
of its | ||||||
9 | employees.
| ||||||
10 | (j) Any rehabilitation facility within the State of | ||||||
11 | Illinois may apply
to the Director to have its employees, | ||||||
12 | annuitants, and their eligible
dependents provided group | ||||||
13 | health coverage under this Act on a non-insured
basis. To | ||||||
14 | participate, a rehabilitation facility must agree to enroll all
| ||||||
15 | of its employees and remit the entire cost of providing such | ||||||
16 | coverage for
its employees, except that the rehabilitation | ||||||
17 | facility shall not be
required to enroll those of its employees | ||||||
18 | who are covered spouses or
dependents under this plan or | ||||||
19 | another group policy or plan providing health
benefits as long | ||||||
20 | as (1) an appropriate official from the rehabilitation
facility | ||||||
21 | attests that each employee not enrolled is a covered spouse or
| ||||||
22 | dependent under this plan or another group policy or plan, and | ||||||
23 | (2) at least
50% of the employees are enrolled and the | ||||||
24 | rehabilitation facility remits
the entire cost of providing | ||||||
25 | coverage to those employees. Employees of a
participating | ||||||
26 | rehabilitation facility who are not enrolled due to coverage
|
| |||||||
| |||||||
1 | under another group health policy or plan may enroll
in the | ||||||
2 | event of a qualifying change in status, special enrollment, | ||||||
3 | special
circumstance as defined by the Director, or during the | ||||||
4 | annual Benefit Choice
Period. A participating rehabilitation | ||||||
5 | facility may also elect
to cover its annuitants. Dependent | ||||||
6 | coverage shall be offered on an optional
basis, with the costs | ||||||
7 | paid by the rehabilitation facility, its employees, or
some | ||||||
8 | combination of the 2 as determined by the rehabilitation | ||||||
9 | facility. The
rehabilitation facility shall be responsible for | ||||||
10 | timely collection and
transmission of dependent premiums.
| ||||||
11 | The Director shall annually determine quarterly rates of | ||||||
12 | payment, subject
to the following constraints:
| ||||||
13 | (1) In the first year of coverage, the rates shall be | ||||||
14 | equal to the amount
normally charged to State employees for | ||||||
15 | elected optional coverages or for
enrolled dependents | ||||||
16 | coverages or other contributory coverages on behalf of
its | ||||||
17 | employees, adjusted for differences between State | ||||||
18 | employees and
employees of the rehabilitation facility in | ||||||
19 | age, sex, geographic location
or other relevant | ||||||
20 | demographic variables, plus an amount sufficient to pay
for | ||||||
21 | the additional administrative costs of providing coverage | ||||||
22 | to employees
of the rehabilitation facility and their | ||||||
23 | dependents.
| ||||||
24 | (2) In subsequent years, a further adjustment shall be | ||||||
25 | made to reflect
the actual prior years' claims experience | ||||||
26 | of the employees of the
rehabilitation facility.
|
| |||||||
| |||||||
1 | Monthly payments by the rehabilitation facility or its | ||||||
2 | employees for
group health benefits shall be deposited in the | ||||||
3 | Local Government Health
Insurance Reserve Fund.
| ||||||
4 | (k) Any domestic violence shelter or service within the | ||||||
5 | State of Illinois
may apply to the Director to have its | ||||||
6 | employees, annuitants, and their
dependents provided group | ||||||
7 | health coverage under this Act on a non-insured
basis. To | ||||||
8 | participate, a domestic violence shelter or service must agree | ||||||
9 | to
enroll all of its employees and pay the entire cost of | ||||||
10 | providing such coverage
for its employees. The domestic | ||||||
11 | violence shelter shall not be required to enroll those of its | ||||||
12 | employees who are covered spouses or dependents under this plan | ||||||
13 | or another group policy or plan providing health benefits as | ||||||
14 | long as (1) an appropriate official from the domestic violence | ||||||
15 | shelter attests that each employee not enrolled is a covered | ||||||
16 | spouse or dependent under this plan or another group policy or | ||||||
17 | plan and (2) at least 50% of the employees are enrolled and the | ||||||
18 | domestic violence shelter remits the entire cost of providing | ||||||
19 | coverage to those employees. Employees of a participating | ||||||
20 | domestic violence shelter who are not enrolled due to coverage | ||||||
21 | under another group health policy or plan may enroll in the | ||||||
22 | event of a qualifying change in status, special enrollment, or | ||||||
23 | special circumstance as defined by the Director or during the | ||||||
24 | annual Benefit Choice Period. A participating domestic | ||||||
25 | violence shelter may also elect
to cover its annuitants. | ||||||
26 | Dependent coverage shall be offered on an optional
basis, with
|
| |||||||
| |||||||
1 | employees, or some combination of the 2 as determined by the | ||||||
2 | domestic violence
shelter or service. The domestic violence | ||||||
3 | shelter or service shall be
responsible for timely collection | ||||||
4 | and transmission of dependent premiums.
| ||||||
5 | The Director shall annually determine rates of payment,
| ||||||
6 | subject to the following constraints:
| ||||||
7 | (1) In the first year of coverage, the rates shall be | ||||||
8 | equal to the
amount normally charged to State employees for | ||||||
9 | elected optional coverages
or for enrolled dependents | ||||||
10 | coverages or other contributory coverages on
behalf of its | ||||||
11 | employees, adjusted for differences between State | ||||||
12 | employees and
employees of the domestic violence shelter or | ||||||
13 | service in age, sex, geographic
location or other relevant | ||||||
14 | demographic variables, plus an amount sufficient
to pay for | ||||||
15 | the additional administrative costs of providing coverage | ||||||
16 | to
employees of the domestic violence shelter or service | ||||||
17 | and their dependents.
| ||||||
18 | (2) In subsequent years, a further adjustment shall be | ||||||
19 | made to reflect
the actual prior years' claims experience | ||||||
20 | of the employees of the domestic
violence shelter or | ||||||
21 | service.
| ||||||
22 | Monthly payments by the domestic violence shelter or | ||||||
23 | service or its employees
for group health insurance shall be | ||||||
24 | deposited in the Local Government Health
Insurance Reserve | ||||||
25 | Fund.
| ||||||
26 | (l) A public community college or entity organized pursuant |
| |||||||
| |||||||
1 | to the
Public Community College Act may apply to the Director | ||||||
2 | initially to have
only annuitants not covered prior to July 1, | ||||||
3 | 1992 by the district's health
plan provided health coverage | ||||||
4 | under this Act on a non-insured basis. The
community college | ||||||
5 | must execute a 2-year contract to participate in the
Local | ||||||
6 | Government Health Plan.
Any annuitant may enroll in the event | ||||||
7 | of a qualifying change in status, special
enrollment, special | ||||||
8 | circumstance as defined by the Director, or during the
annual | ||||||
9 | Benefit Choice Period.
| ||||||
10 | The Director shall annually determine monthly rates of | ||||||
11 | payment subject to
the following constraints: for those | ||||||
12 | community colleges with annuitants
only enrolled, first year | ||||||
13 | rates shall be equal to the average cost to cover
claims for a | ||||||
14 | State member adjusted for demographics, Medicare
| ||||||
15 | participation, and other factors; and in the second year, a | ||||||
16 | further adjustment
of rates shall be made to reflect the actual | ||||||
17 | first year's claims experience
of the covered annuitants.
| ||||||
18 | (l-5) The provisions of subsection (l) become inoperative | ||||||
19 | on July 1, 1999.
| ||||||
20 | (m) The Director shall adopt any rules deemed necessary for
| ||||||
21 | implementation of this amendatory Act of 1989 (Public Act | ||||||
22 | 86-978).
| ||||||
23 | (n) Any child advocacy center within the State of Illinois | ||||||
24 | may apply to the Director to have its employees, annuitants, | ||||||
25 | and their dependents provided group health coverage under this | ||||||
26 | Act on a non-insured basis. To participate, a child advocacy |
| |||||||
| |||||||
1 | center must agree to enroll all of its employees and pay the | ||||||
2 | entire cost of providing coverage for its employees. The child
| ||||||
3 | advocacy center shall not be required to enroll those of its
| ||||||
4 | employees who are covered spouses or dependents under this plan
| ||||||
5 | or another group policy or plan providing health benefits as
| ||||||
6 | long as (1) an appropriate official from the child advocacy
| ||||||
7 | center attests that each employee not enrolled is a covered
| ||||||
8 | spouse or dependent under this plan or another group policy or
| ||||||
9 | plan and (2) at least 50% of the employees are enrolled and the | ||||||
10 | child advocacy center remits the entire cost of providing | ||||||
11 | coverage to those employees. Employees of a participating child | ||||||
12 | advocacy center who are not enrolled due to coverage under | ||||||
13 | another group health policy or plan may enroll in the event of | ||||||
14 | a qualifying change in status, special enrollment, or special | ||||||
15 | circumstance as defined by the Director or during the annual | ||||||
16 | Benefit Choice Period. A participating child advocacy center | ||||||
17 | may also elect to cover its annuitants. Dependent coverage | ||||||
18 | shall be offered on an optional basis, with the costs paid by | ||||||
19 | the child advocacy center, its employees, or some combination | ||||||
20 | of the 2 as determined by the child advocacy center. The child | ||||||
21 | advocacy center shall be responsible for timely collection and | ||||||
22 | transmission of dependent premiums. | ||||||
23 | The Director shall annually determine rates of payment, | ||||||
24 | subject to the following constraints: | ||||||
25 | (1) In the first year of coverage, the rates shall be | ||||||
26 | equal to the amount normally charged to State employees for |
| |||||||
| |||||||
1 | elected optional coverages or for enrolled dependents | ||||||
2 | coverages or other contributory coverages on behalf of its | ||||||
3 | employees, adjusted for differences between State | ||||||
4 | employees and employees of the child advocacy center in | ||||||
5 | age, sex, geographic location, or other relevant | ||||||
6 | demographic variables, plus an amount sufficient to pay for | ||||||
7 | the additional administrative costs of providing coverage | ||||||
8 | to employees of the child advocacy center and their | ||||||
9 | dependents. | ||||||
10 | (2) In subsequent years, a further adjustment shall be | ||||||
11 | made to reflect the actual prior years' claims experience | ||||||
12 | of the employees of the child advocacy center. | ||||||
13 | Monthly payments by the child advocacy center or its | ||||||
14 | employees for group health insurance shall be deposited into | ||||||
15 | the Local Government Health Insurance Reserve Fund. | ||||||
16 | (Source: P.A. 97-695, eff. 7-1-12; 98-488, eff. 8-16-13.)
| ||||||
17 | (5 ILCS 375/10.5 new) | ||||||
18 | Sec. 10.5. Ending State-funded benefits for retired | ||||||
19 | elected officials. | ||||||
20 | (a) For the purposes of this Section, "retired elected | ||||||
21 | official" means an annuitant under Article 2 of the Illinois | ||||||
22 | Pension Code, a person receiving a survivor's annuity under | ||||||
23 | Article 2 of the Pension Code, or a member, not otherwise | ||||||
24 | covered by this Act, who has retired as a participating member | ||||||
25 | under Article 2 of the Pension Code but is ineligible for the |
| |||||||
| |||||||
1 | retirement annuity under Section 2-119 of the Illinois Pension | ||||||
2 | Code. | ||||||
3 | (b) Notwithstanding any other provision of law, on and | ||||||
4 | after the effective date of this amendatory Act of the 98th | ||||||
5 | General Assembly, the State shall not pay or otherwise make | ||||||
6 | contributions toward the costs of any group life insurance | ||||||
7 | program or program of health benefits provided under this Act | ||||||
8 | for retired elected officials. | ||||||
9 | (c) Notwithstanding any other provision of law, a retired | ||||||
10 | elected official enrolled in any group life insurance program | ||||||
11 | or program of health benefits provided under this Act shall pay | ||||||
12 | the entirety of the cost of coverage, unless he or she has | ||||||
13 | waived or terminated coverage under subsection (d) of this | ||||||
14 | Section. The cost of coverage shall be determined by the | ||||||
15 | Director. Nothing in this Section shall be construed to prevent | ||||||
16 | any retired elected official from receiving group health or | ||||||
17 | life insurance benefits under this Act, where that retired | ||||||
18 | elected official contributes the entirety of the cost of | ||||||
19 | coverage. | ||||||
20 | (d) Any retired elected official may waive or terminate | ||||||
21 | coverage in
the program of health benefits or group life | ||||||
22 | insurance. Any retired elected official
who has waived or | ||||||
23 | terminated coverage may enroll or re-enroll in the
program of | ||||||
24 | group health benefits or group life insurance only during the | ||||||
25 | annual benefit choice period,
as determined by the Director; | ||||||
26 | except that in the event of termination of
coverage due to |
| |||||||
| |||||||
1 | nonpayment of premiums, the retired elected official
may not | ||||||
2 | re-enroll in the program.
| ||||||
3 | Section 99. Effective date. This Act takes effect upon | ||||||
4 | becoming law.
|