Bill Text: IL SB1245 | 2013-2014 | 98th General Assembly | Amended
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Amends the Public Safety Employee Benefits Act. Defines "catastrophic injury" to mean the consequences of an injury that permanently prevent an individual from performing any gainful work. Effective immediately.
Spectrum: Bipartisan Bill
Status: (Passed) 2013-08-27 - Public Act . . . . . . . . . 98-0561 [SB1245 Detail]
Download: Illinois-2013-SB1245-Amended.html
Bill Title: Amends the Public Safety Employee Benefits Act. Defines "catastrophic injury" to mean the consequences of an injury that permanently prevent an individual from performing any gainful work. Effective immediately.
Spectrum: Bipartisan Bill
Status: (Passed) 2013-08-27 - Public Act . . . . . . . . . 98-0561 [SB1245 Detail]
Download: Illinois-2013-SB1245-Amended.html
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1 | AMENDMENT TO SENATE BILL 1245
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2 | AMENDMENT NO. ______. Amend Senate Bill 1245, AS AMENDED, | ||||||
3 | by replacing everything after the enacting clause with the | ||||||
4 | following:
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5 | "Section 5. The Public Safety Employee Benefits Act is | ||||||
6 | amended by changing Section 10 as follows:
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7 | (820 ILCS 320/10)
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8 | Sec. 10. Required health coverage benefits.
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9 | (a) An employer who employs a full-time law enforcement, | ||||||
10 | correctional or
correctional probation officer, or firefighter | ||||||
11 | (hereinafter referred to as "injured employee") , who, on or | ||||||
12 | after the effective
date of this Act suffers a catastrophic | ||||||
13 | injury or is killed in the line of duty
shall pay the entire | ||||||
14 | premium of the employer's health insurance plan for the
injured | ||||||
15 | employee, the injured employee's spouse, and for each dependent | ||||||
16 | child
of the injured employee until the child reaches the age |
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1 | of majority or until
the end of the calendar year in which the | ||||||
2 | child reaches the age of 25 if the
child continues to be | ||||||
3 | dependent for support or the child is a full-time or
part-time | ||||||
4 | student and is dependent for support. The term "health | ||||||
5 | insurance
plan" does not include supplemental benefits that are | ||||||
6 | not part of the basic
group health insurance plan.
If the
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7 | injured employee subsequently dies, the employer shall | ||||||
8 | continue to pay the
entire health insurance premium for the | ||||||
9 | surviving spouse until remarried and
for the dependent children | ||||||
10 | under the conditions established in this Section.
However:
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11 | (1) Health insurance benefits payable from any other | ||||||
12 | source shall reduce
benefits payable under this Section.
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13 | (2) It is unlawful for a person to willfully and | ||||||
14 | knowingly make, or cause
to be made, or to assist, conspire | ||||||
15 | with, or urge another to make, or cause to
be made, any | ||||||
16 | false, fraudulent, or misleading oral or written statement | ||||||
17 | to
obtain health insurance coverage as provided under this | ||||||
18 | Section. A violation
of this item is a Class A misdemeanor.
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19 | (3) Upon conviction for a violation described in item | ||||||
20 | (2), a law
enforcement, correctional or correctional | ||||||
21 | probation officer, or other
beneficiary who receives or | ||||||
22 | seeks to receive health insurance benefits under
this | ||||||
23 | Section shall forfeit the right to receive health insurance | ||||||
24 | benefits and
shall reimburse the employer for all benefits | ||||||
25 | paid due to the fraud or other
prohibited activity. For | ||||||
26 | purposes of this item, "conviction" means a
determination |
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1 | of guilt that is the result of a plea or trial, regardless | ||||||
2 | of
whether adjudication is withheld.
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3 | (b) In order for the law enforcement, correctional or | ||||||
4 | correctional probation
officer, firefighter, spouse, or | ||||||
5 | dependent children to be eligible for
insurance coverage under | ||||||
6 | this Act, the injury or death must have occurred as
the result | ||||||
7 | of the officer's response to fresh pursuit, the officer or
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8 | firefighter's response to what is reasonably believed to be an | ||||||
9 | emergency, an
unlawful act perpetrated by another, or during | ||||||
10 | the investigation of a criminal
act. Nothing in this Section | ||||||
11 | shall be construed to limit health insurance
coverage or | ||||||
12 | pension benefits for which the officer, firefighter, spouse, or
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13 | dependent children may otherwise be eligible.
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14 | (c) An injured employee subject to this Act shall be | ||||||
15 | required to file a report with his or her employer as | ||||||
16 | prescribed in this Section. The Commission on Government | ||||||
17 | Forecasting and Accountability (COGFA) shall design the form | ||||||
18 | and prescribe the content of the report. Within 60 days after | ||||||
19 | the effective date of this amendatory Act of the 98th General | ||||||
20 | Assembly, COGFA shall design and remit a copy of this form to | ||||||
21 | all employers subject to this Act. The form shall include the | ||||||
22 | following: | ||||||
23 | (1) employment by the injured employee within the | ||||||
24 | previous 24-month period; | ||||||
25 | (2) compensation earned by the injured employee as a | ||||||
26 | result of the employment; |
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1 | (3) the nature of the injury that entitled the injured | ||||||
2 | employee to a duty disability benefit and benefits as | ||||||
3 | provided under this Act listing the part of the body | ||||||
4 | affected, explaining how it was affected, and including the | ||||||
5 | medical diagnosis, if known; | ||||||
6 | (4) whether the injured employee or his or her spouse | ||||||
7 | has been offered or has access to any insurance from the | ||||||
8 | injured employee's employment or his or her spouse's | ||||||
9 | employment; and | ||||||
10 | (5) whether the injured employee or his or her spouse | ||||||
11 | is currently enrolled in any insurance plan from another | ||||||
12 | source. | ||||||
13 | Within 30 days after receipt of this form, an employer | ||||||
14 | shall notify any employee receiving benefits under this Act of | ||||||
15 | that employee's obligation to file a report under this Section. | ||||||
16 | An employee receiving benefits under this Act must complete and | ||||||
17 | return this form to the employer within 30 days of receipt of | ||||||
18 | such form. Any employee who has been given notice as provided | ||||||
19 | under this Section and who fails to timely file a report under | ||||||
20 | this Section within 30 days after receipt of this form shall be | ||||||
21 | notified by the employer that he or she has 30 days to submit | ||||||
22 | the report or risk losing his or her benefits provided under | ||||||
23 | this Act. An employer may suspend premium payments for an | ||||||
24 | employee who fails to file this report with the employer 30 | ||||||
25 | days after receiving this notice. The employee is responsible | ||||||
26 | for ensuring that premiums are paid during the period of |
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1 | suspension. Employers shall return this form to COGFA within 30 | ||||||
2 | days after receiving the form from the employee. | ||||||
3 | Any information collected by the employer under this | ||||||
4 | Section shall be exempt from the requirements of the Freedom of | ||||||
5 | Information Act except for data collected in the aggregate that | ||||||
6 | does not reveal any personal information concerning the injured | ||||||
7 | employee. | ||||||
8 | By July 1 of every odd-numbered year, beginning in 2015, | ||||||
9 | employers subject to this Act must send a form to all employees | ||||||
10 | eligible for benefits under this Act. The employee must | ||||||
11 | complete and return this form by August 1 of that year. Any | ||||||
12 | employee who has been given notice as provided under this | ||||||
13 | Section and who fails to timely file a completed form under | ||||||
14 | this Section within 30 days after receipt of this form shall be | ||||||
15 | notified by the employer that he or she has 30 days to submit | ||||||
16 | the form or risk losing his or her benefits provided under this | ||||||
17 | Act. An employer may suspend premium payments for an employee | ||||||
18 | who fails to complete and file this form with the employer 30 | ||||||
19 | days after receiving this notice. The employee is responsible | ||||||
20 | for ensuring that premiums are paid during the period of | ||||||
21 | suspension. The employer shall resume premium payments upon | ||||||
22 | receipt of the completed form. Employers shall return this form | ||||||
23 | to COGFA within 30 days after receiving the form from the | ||||||
24 | employee. | ||||||
25 | (d) An employer subject to this Act shall file a claims | ||||||
26 | report with COGFA. COGFA shall design the form and prescribe |
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1 | the content of the report. Within 60 days after the effective | ||||||
2 | date of this amendatory Act of the 98th General Assembly, and | ||||||
3 | by July 1 of every odd-numbered year thereafter beginning in | ||||||
4 | 2015, COGFA shall remit a copy of this form to all employers | ||||||
5 | subject to this Act. An employer covered under this Act shall | ||||||
6 | file a copy of this report with COGFA within 120 days after | ||||||
7 | receipt of the form. | ||||||
8 | The first claims report filed with COGFA under this Section | ||||||
9 | shall set forth all information gathered pursuant to this | ||||||
10 | Section and, when available, shall submit the information | ||||||
11 | required under this Section for each of the 5 years prior to | ||||||
12 | the year in which this amendatory Act of the 98th General | ||||||
13 | Assembly became law. All claims reports thereafter shall set | ||||||
14 | forth the required information for the 24-month period ending | ||||||
15 | on June 30 preceding the deadline date for filing the report. | ||||||
16 | The claims report shall, at a minimum, contain the following | ||||||
17 | information: | ||||||
18 | (1) the number of claims filed under this Act during | ||||||
19 | the reporting period; | ||||||
20 | (2) the number of claims awarded under this Act during | ||||||
21 | the reporting period; | ||||||
22 | (3) the dollar amount of all claims awarded under this | ||||||
23 | Act during the reporting period; | ||||||
24 | (4) the number of claims paid under this Act during the | ||||||
25 | reporting period regardless of when the claim was awarded; | ||||||
26 | (5) the dollar amount of all claims paid under this Act |
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1 | during the reporting period regardless of when the claim | ||||||
2 | was awarded; | ||||||
3 | (6) the annual cost of the benefit and any available | ||||||
4 | long-term cost projections; | ||||||
5 | (7) the nature of the injury as described by the | ||||||
6 | injured employee under item (3) of subsection (c); | ||||||
7 | (8) any employment during the annual reporting period; | ||||||
8 | (9) the compensation earned as a result of that | ||||||
9 | employment; and | ||||||
10 | (10) any offered or accessible insurance options | ||||||
11 | through the injured employee's employment or his or her | ||||||
12 | spouse's employment. | ||||||
13 | The claims report shall redact any information as required | ||||||
14 | by the Health Insurance Portability and Accountability Act of | ||||||
15 | 1996 (HIPAA). Any information submitted to COGFA shall not | ||||||
16 | reveal any personal information of the injured employee. | ||||||
17 | Whenever possible, communication between COGFA and employers | ||||||
18 | as required by this Act shall be through electronic means. | ||||||
19 | (e) By June 1, 2014, and by January 1 of every | ||||||
20 | even-numbered year thereafter beginning in 2016, COGFA shall | ||||||
21 | submit a report to the Governor and General Assembly setting | ||||||
22 | forth the information received under subsections (c) and (d). | ||||||
23 | The report shall aggregate data in such a way as to not reveal | ||||||
24 | the identity of any singular beneficiary. The requirement for | ||||||
25 | reporting to the General Assembly shall be satisfied by filing | ||||||
26 | copies of the report with the Speaker, Minority Leader, and |
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1 | Clerk of the House of Representatives, the President, Minority | ||||||
2 | Leader, and Secretary of the Senate, the Legislative Research | ||||||
3 | Unit as required under Section 3.1 of the General Assembly | ||||||
4 | Organization Act, and the State Government Report Distribution | ||||||
5 | Center for the General Assembly as required under paragraph (t) | ||||||
6 | of Section 7 of the State Library Act. COGFA shall make this | ||||||
7 | report available electronically on a publicly accessible | ||||||
8 | website. | ||||||
9 | (Source: P.A. 90-535, eff. 11-14-97.)
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10 | Section 99. Effective date. This Act takes effect upon | ||||||
11 | becoming law.".
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