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 "PSEBA recipient") , 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 PSEBA | ||||||
15 | recipient
injured employee , the PSEBA recipient's injured | ||||||
16 | employee's spouse, and for each dependent child
of the PSEBA |
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1 | recipient injured employee until the child reaches the age of | ||||||
2 | majority or until
the end of the calendar year in which the | ||||||
3 | child reaches the age of 25 if the
child continues to be | ||||||
4 | dependent for support or the child is a full-time or
part-time | ||||||
5 | student and is dependent for support. The term "health | ||||||
6 | insurance
plan" does not include supplemental benefits that are | ||||||
7 | not part of the basic
group health insurance plan.
If the PSEBA | ||||||
8 | recipient
injured employee subsequently dies, the employer | ||||||
9 | shall continue to pay the
entire health insurance premium for | ||||||
10 | the surviving spouse until remarried and
for the dependent | ||||||
11 | children under the conditions established in this Section.
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12 | However:
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13 | (1) Health insurance benefits payable from any other | ||||||
14 | source shall reduce
benefits payable under this Section.
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15 | (2) It is unlawful for a person to willfully and | ||||||
16 | knowingly make, or cause
to be made, or to assist, conspire | ||||||
17 | with, or urge another to make, or cause to
be made, any | ||||||
18 | false, fraudulent, or misleading oral or written statement | ||||||
19 | to
obtain health insurance coverage as provided under this | ||||||
20 | Section. A violation
of this item is a Class A misdemeanor.
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21 | (3) Upon conviction for a violation described in item | ||||||
22 | (2), a law
enforcement, correctional or correctional | ||||||
23 | probation officer, or other
beneficiary who receives or | ||||||
24 | seeks to receive health insurance benefits under
this | ||||||
25 | Section shall forfeit the right to receive health insurance | ||||||
26 | benefits and
shall reimburse the employer for all benefits |
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1 | paid due to the fraud or other
prohibited activity. For | ||||||
2 | purposes of this item, "conviction" means a
determination | ||||||
3 | of guilt that is the result of a plea or trial, regardless | ||||||
4 | of
whether adjudication is withheld.
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5 | (b) In order for the law enforcement, correctional or | ||||||
6 | correctional probation
officer, firefighter, spouse, or | ||||||
7 | dependent children to be eligible for
insurance coverage under | ||||||
8 | this Act, the injury or death must have occurred as
the result | ||||||
9 | of the officer's response to fresh pursuit, the officer or
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10 | firefighter's response to what is reasonably believed to be an | ||||||
11 | emergency, an
unlawful act perpetrated by another, or during | ||||||
12 | the investigation of a criminal
act. Nothing in this Section | ||||||
13 | shall be construed to limit health insurance
coverage or | ||||||
14 | pension benefits for which the officer, firefighter, spouse, or
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15 | dependent children may otherwise be eligible.
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16 | (c) A PSEBA recipient subject to this Act shall be required | ||||||
17 | to file a report with his or her employer as prescribed in this | ||||||
18 | Section. The Commission on Government Forecasting and | ||||||
19 | Accountability (COGFA) shall design the form and prescribe the | ||||||
20 | content of the report in cooperation with one statewide labor | ||||||
21 | organization representing police, one statewide labor | ||||||
22 | organization representing firefighters employed by at least | ||||||
23 | 100 municipalities in this State, that is affiliated with the | ||||||
24 | Illinois State Federation of Labor, one statewide organization | ||||||
25 | representing municipalities, and one regional organization | ||||||
26 | representing municipalities. COGFA may accept comment from any |
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1 | source, but shall not be required to solicit public comment. | ||||||
2 | Within 60 days after the effective date of this amendatory Act | ||||||
3 | of the 98th General Assembly, COGFA shall design and remit a | ||||||
4 | copy of this form to all employers subject to this Act. The | ||||||
5 | form shall include the following: | ||||||
6 | (1) employment by the PSEBA recipient within the | ||||||
7 | previous 24-month period or since the time the PSEBA | ||||||
8 | recipient began receiving benefits under this Act if less | ||||||
9 | than 24 months; | ||||||
10 | (2) compensation earned by the PSEBA recipient as a | ||||||
11 | result of the employment; | ||||||
12 | (3) the nature of the injury that entitled the PSEBA | ||||||
13 | recipient to a duty disability benefit and benefits as | ||||||
14 | provided under this Act listing the part of the body | ||||||
15 | affected, explaining how it was affected, and including the | ||||||
16 | medical diagnosis, if known; | ||||||
17 | (4) whether the PSEBA recipient or his or her spouse | ||||||
18 | has been offered or has access to any insurance from the | ||||||
19 | PSEBA recipient's employment or his or her spouse's | ||||||
20 | employment; | ||||||
21 | (5) whether the PSEBA recipient or his or her spouse is | ||||||
22 | currently enrolled in any insurance plan from another | ||||||
23 | source; | ||||||
24 | (6) a description of benefits offered by the PSEBA | ||||||
25 | recipient's employer or the employer of his or her spouse, | ||||||
26 | including policy limits, co-pay requirements, and |
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1 | deductibles; and | ||||||
2 | (7) the cost of the insurance offered by the PSEBA | ||||||
3 | recipient's employer or the employer of his or her spouse. | ||||||
4 | Within 30 days after receipt of this form, an employer | ||||||
5 | shall notify any PSEBA recipient receiving benefits under this | ||||||
6 | Act of that recipient's obligation to file a report under this | ||||||
7 | Section. A PSEBA recipient receiving benefits under this Act | ||||||
8 | must complete and return this form to the employer within 60 | ||||||
9 | days of receipt of such form. Any PSEBA recipient who has been | ||||||
10 | given notice as provided under this Section and who fails to | ||||||
11 | timely file a report under this Section within 60 days after | ||||||
12 | receipt of this form shall be notified by the employer that he | ||||||
13 | or she has 30 days to submit the report or risk incurring the | ||||||
14 | cost of his or her benefits provided under this Act. An | ||||||
15 | employer may seek reimbursement for premium payments for a | ||||||
16 | PSEBA recipient who fails to file this report with the employer | ||||||
17 | 30 days after receiving this notice. The PSEBA recipient is | ||||||
18 | responsible for reimbursing the employer for premiums paid | ||||||
19 | during the period the report is due and not filed. Employers | ||||||
20 | shall return this form to COGFA within 30 days after receiving | ||||||
21 | the form from the PSEBA recipient. | ||||||
22 | Any information collected by the employer under this | ||||||
23 | Section shall be exempt from the requirements of the Freedom of | ||||||
24 | Information Act except for data collected in the aggregate that | ||||||
25 | does not reveal any personal information concerning the PSEBA | ||||||
26 | recipient. |
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1 | By July 1 of every odd-numbered year, beginning in 2015, | ||||||
2 | employers subject to this Act must send a form to all PSEBA | ||||||
3 | recipients eligible for benefits under this Act. The PSEBA | ||||||
4 | recipient must complete and return this form by September 1 of | ||||||
5 | that year. Any PSEBA recipient who has been given notice as | ||||||
6 | provided under this Section and who fails to timely file a | ||||||
7 | completed form under this Section within 60 days after receipt | ||||||
8 | of this form shall be notified by the employer that he or she | ||||||
9 | has 30 days to submit the form or risk incurring the costs of | ||||||
10 | his or her benefits provided under this Act. The PSEBA | ||||||
11 | recipient is responsible for reimbursing the employer for | ||||||
12 | premiums paid during the period the report is due and not | ||||||
13 | filed. The employer shall resume premium payments upon receipt | ||||||
14 | of the completed form. Employers shall return this form to | ||||||
15 | COGFA within 30 days after receiving the form from the PSEBA | ||||||
16 | recipient. | ||||||
17 | (d) An employer subject to this Act shall file a claims | ||||||
18 | report with COGFA. COGFA shall design the form and prescribe | ||||||
19 | the content of the report in cooperation with one statewide | ||||||
20 | labor organization representing police, one statewide labor | ||||||
21 | organization representing firefighters employed by at least | ||||||
22 | 100 municipalities in this State, that is affiliated with the | ||||||
23 | Illinois State Federation of Labor, one statewide organization | ||||||
24 | representing municipalities, and one regional organization | ||||||
25 | representing municipalities. Within 60 days after the | ||||||
26 | effective date of this amendatory Act of the 98th General |
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1 | Assembly, and by July 1 of every odd-numbered year thereafter | ||||||
2 | beginning in 2015, COGFA shall remit a copy of this form to all | ||||||
3 | employers subject to this Act. An employer covered under this | ||||||
4 | Act shall file a copy of this report with COGFA within 120 days | ||||||
5 | after receipt of the form. | ||||||
6 | The first claims report filed with COGFA under this Section | ||||||
7 | shall set forth all information gathered pursuant to this | ||||||
8 | Section and, when available, shall submit the information | ||||||
9 | required under this Section for each of the 5 years prior to | ||||||
10 | the year in which this amendatory Act of the 98th General | ||||||
11 | Assembly became law. All claims reports thereafter shall set | ||||||
12 | forth the required information for the 24-month period ending | ||||||
13 | on June 30 preceding the deadline date for filing the report. | ||||||
14 | The claims report shall, at a minimum, contain the following | ||||||
15 | information: | ||||||
16 | (1) the number of claims filed under this Act during | ||||||
17 | the reporting period; | ||||||
18 | (2) the number of claims awarded under this Act during | ||||||
19 | the reporting period; | ||||||
20 | (3) the dollar amount of all claims awarded under this | ||||||
21 | Act during the reporting period; | ||||||
22 | (4) the number of claims paid under this Act during the | ||||||
23 | reporting period regardless of when the claim was awarded; | ||||||
24 | (5) the dollar amount of all claims paid under this Act | ||||||
25 | during the reporting period regardless of when the claim | ||||||
26 | was awarded; |
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1 | (6) the annual cost of the benefit; | ||||||
2 | (7) the nature of the injury as described by the PSEBA | ||||||
3 | recipient under item (3) of subsection (c); | ||||||
4 | (8) any employment during the annual reporting period; | ||||||
5 | (9) the compensation earned as a result of that | ||||||
6 | employment; | ||||||
7 | (10) any offered or accessible insurance options | ||||||
8 | through the PSEBA recipient's employment or his or her | ||||||
9 | spouse's employment; | ||||||
10 | (11) a description of benefits offered by the PSEBA | ||||||
11 | recipient's employer or the employer of his or her spouse, | ||||||
12 | including policy limits, co-pay requirements, and | ||||||
13 | deductibles; and | ||||||
14 | (12) the cost of the insurance offered by the PSEBA | ||||||
15 | recipient's employer or the employer of his or her spouse. | ||||||
16 | The claims report shall redact any information as required | ||||||
17 | by the Health Insurance Portability and Accountability Act of | ||||||
18 | 1996 (HIPAA). Any information submitted to COGFA shall not | ||||||
19 | reveal any personal information of the PSEBA recipient. | ||||||
20 | Whenever possible, communication between COGFA and employers | ||||||
21 | as required by this Act shall be through electronic means. | ||||||
22 | (e) By June 1, 2014, and by January 1 of every | ||||||
23 | even-numbered year thereafter beginning in 2016, COGFA shall | ||||||
24 | submit a report to the Governor and General Assembly setting | ||||||
25 | forth the information received under subsections (c) and (d). | ||||||
26 | The report shall aggregate data in such a way as to not reveal |
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1 | the identity of any singular beneficiary. The requirement for | ||||||
2 | reporting to the General Assembly shall be satisfied by filing | ||||||
3 | copies of the report with the Speaker, Minority Leader, and | ||||||
4 | Clerk of the House of Representatives, the President, Minority | ||||||
5 | Leader, and Secretary of the Senate, the Legislative Research | ||||||
6 | Unit as required under Section 3.1 of the General Assembly | ||||||
7 | Organization Act, and the State Government Report Distribution | ||||||
8 | Center for the General Assembly as required under paragraph (t) | ||||||
9 | of Section 7 of the State Library Act. COGFA shall make this | ||||||
10 | report available electronically on a publicly accessible | ||||||
11 | website. | ||||||
12 | (Source: P.A. 90-535, eff. 11-14-97.)
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13 | Section 99. Effective date. This Act takes effect upon | ||||||
14 | becoming law.".
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